Green Room

Health records ‘data security,’ Canada-style

posted at 11:33 am on December 3, 2013 by

Yesterday, we showcased a monstrous byproduct of Britain’s national healthcare system. Today, we hop across the pond to do the same. This is creepy (via Brit Hume):

Ellen Richardson went to Pearson airport on Monday full of joy about flying to New York City and from there going on a 10-day Caribbean cruise for which she’d paid about $6,000. But a U.S. Customs and Border Protection agent with the Department of Homeland Security killed that dream when he denied her entry. “I was turned away, I was told, because I had a hospitalization in the summer of 2012 for clinical depression,’’ said Richardson, who is a paraplegic and set up her cruise in collaboration with a March of Dimes group of about 12 others. The Weston woman was told by the U.S. agent she would have to get “medical clearance’’ and be examined by one of only three doctors in Toronto whose assessments are accepted by Homeland Security. She was given their names and told a call to her psychiatrist “would not suffice.’’

First off, good luck securing a last-minute doctor’s appointment in Canada.  Secondly, it gets weirder:

At the time, Richardson said, she was so shocked and devastated by what was going on, she wasn’t thinking about how U.S. authorities could access her supposedly private medical information. “I was so aghast. I was saying, ‘I don’t understand this. What is the problem?’ I was so looking forward to getting away . . . I’d even brought a little string of Christmas lights I was going to string up in the cabin. . . . It’s not like I can just book again right away,’’ she said, referring to the time and planning that goes into taking a trip as a disabled person. Richardson said she’d had no discussion whatsoever with the agent at the airport about her medical history or background.

An inquiry into how this happened is underway, with Ms. Richardson’s MP calling the episode “enormously troubling.”  But I’m sure Americans have nothing to fear regarding healthcare-related data security breaches.  After all, Kathleen Sebelius “feels like” Healthcare.gov is secure.  Case closed, right?

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One.

Stop slagging Canada. It just shows off your ignorance.

Two.

This was a headline story and ‘astonerii’ and I discussed it at length. The woman in question wrote a book and has a website promoting it. Try http://ellenrichardson.ca

There is no privacy issue since she has published the details herself.

gh on December 3, 2013 at 11:41 AM

Did the border guard access her book information?? Is that how he found she had been depressed??

Is being depressed a reason to deny entry???

KMC1 on December 3, 2013 at 12:04 PM

Isn’t the question ,why was she refused entry to the U.S?

mags on December 3, 2013 at 12:05 PM

So, they keep her out, but they let Piers Morgan stay? Something is wrong in topsy-turvy land.

GWB on December 3, 2013 at 12:11 PM

gh, I like Canada. But I want nothing to do with their healthcare system. It’s not “ignorant” to oppose long waiting lists for surgery, and lotteries for the privilege of seeing a doctor.

You believe the US government barred this woman from entry because of her book and website about struggling with depression? I tend to agree with her MP that no matter the explanation, this whole episode is troubling. Is battling depression a crime? A national security risk? She also suggested that the official had access to her records.

Guy Benson on December 3, 2013 at 1:26 PM

I agree, stop bashing the Canadian health care system.

First, for non-emergency surgery, yes indeed, you do wait for a time; it can be anywhere from a month to six months. I repeat: non-emergency surgery. For emergency and serious illnesses, there is rapid treatment within that week.

Second, there is no such thing as a ‘lottery to obtain a doctor’. Kindly prove such an assertion. There are no problems finding a doctor – and unlike the system the US is setting up, where many doctors are going to refuse to take patients on, eg, Medicaid, no such problems exist in Canada.

Third, the payments come out of the federal and in particular, provincial taxation. Health care is not run by the federal centralist government but by the provinces. And, there are no deductibles; your treatments and visits are paid from day one. Therefore, the focus is on preventative care, while the high deductibles and enormous monthly costs in Obamacare mean that the focus is not on preventative care but on risk and traumatic care.

As for her entry to the US, it was the US customs and border control that barred her entry – and as others have noted, the only question is: How did a foreign government (the US) obtain access to the private health care records of a, I assume, Canadian citizen. I suspect that we are not being given the full story.

ETAB on December 3, 2013 at 2:11 PM

gh, I like Canada. But I want nothing to do with their healthcare system. It’s not “ignorant” to oppose long waiting lists for surgery, and lotteries for the privilege of seeing a doctor.

Come January, you are going to have more people without healthcare in the US than the entire population of Canada. People in glass houses …

I do not favour socialized medicine but the horror stories written about the Canadian version in the US media are grossly exaggerated. It is nothing like the NHS in Britain, which seems to be a real nightmare. The NHS was not too bad when I was a small child though (I left the UK when I was 9).

You believe the US government barred this woman from entry because of her book and website about struggling with depression? I tend to agree with her MP that no matter the explanation, this whole episode is troubling. Is battling depression a crime? A national security risk? She also suggested that the official had access to her records.
Guy Benson on December 3, 2013 at 1:26 PM

No I don’t believe any of that. You seem to have severely impaired reading comprehension or a wild imagination. Either of those might explain your articles on hot-air. Just read exactly what I wrote above without filling in between the lines with your own interpretation.

gh on December 3, 2013 at 2:18 PM

I checked the link to her book and, as I thought, we are not being given the full story. I suspect that she was barred from the USA, not because of clinical depression or its hospitalization, but because of her three suicide attempts (one of which paralyzed her), which all brought her into contact with the judicial system.

These are no longer crimes (at one time they were!) but I suspect that they are on file and the US border control would have been concerned about her going into the US to carry out yet another attempt.

ETAB on December 3, 2013 at 2:20 PM

Second, there is no such thing as a ‘lottery to obtain a doctor’. Kindly prove such an assertion. There are no problems finding a doctor – and unlike the system the US is setting up, where many doctors are going to refuse to take patients on, eg, Medicaid, no such problems exist in Canada.
ETAB on December 3, 2013 at 2:11 PM

Where I live, in Western Canada, the family doctors have long waiting lists. You have to wait for someone to die or move in order to get a family doctor.

When I had the flu my husband called his family doctor and the lady at the reception told him bluntly that his doctor doesn’t take street patients. It’s not the doctor’s fault, he is a very nice man. It’s the system.

If you don’t have a family doctor you have to go to a Medical Clinic. That’s a lottery, because you never know what kind of doctor you will get.

Gelsomina on December 3, 2013 at 2:46 PM

gelsomina – going to a Medical Clinic is NOT a lottery, which, by definition, means that you either get X (the prize) or do not get X. However, going to a Medical Clinic, and in towns and cities there are multiple such walk-in clinics means that you will see a doctor. It doesn’t mean that you will not be lucky enough (win the lottery) and will be unable to see a doctor.

As for the doctors in the clinics, they are all registered practictioners, exactly as is a family dcotor. The difference? They prefer to work in a clinic rather than set up their own private practice. And you can get inadequate and incompetent family doctors as well (we all have such anecdotal experiences). So, your assumption that ALL family doctors are good, and ALL medical clinic doctors are bad, is empirically false.

My question to you, is that you didn’t seem to have any family dcotor of your own – all your life?! Why would you have to ask for your husband’s doctor? Or is it the case that you had just moved there and hadn’t set up your own doctor?

Certainly, in Canada, and elsewhere, doctors have a full list of clients and some cannot take on new patients. But that is the case everywhere and has nothing to do with how the doctors are funded. And in the US, with Obamacare, the fact that doctors are leaving the system; that they are refusing to take on Medicare and Medicaid patients, and – that dangerous, dangerous setup of high deductibles, is not a top functioning medical system.

ETAB on December 3, 2013 at 3:11 PM

Certainly, in Canada, and elsewhere, doctors have a full list of clients and some cannot take on new patients. But that is the case everywhere and has nothing to do with how the doctors are funded.

I absolutely disagree with you on this point.
I have relocated several times in the last 20 years for employment. I have NEVER had a problem finding a new GP during that time.

I have had nothing but very good experiences with the US health care system over my lifetime.

We allowed the Marxists to throw the baby out with the bath water when we allowed obozocare to pass.

KMC1 on December 3, 2013 at 3:58 PM

KMC1 – just because you relocated 20 times and found a new GP, does not mean that ALL locations, rural and urban, central and peripheral, are stock-full of doctors able to take on new patients. Rural locations in particular are always problematic in all countries.

As for the US healthcare system, Before Obama, I agree that it was top quality care and very good; indeed, it enabled robust research and development, up-to-date skills and experience – and superb hospitals and care. So why change it?

As for the ‘false-cause’ explanation given by Obama that the reason for his destroying the excellent health care system that was in place in the US -those ’40 million uninsured’ – well, that ignored that many did not require insurance (which must always be understood as not for general health preventative care but for risk) and were prepared to pay for that general preventative care outside of risk-insurance.

Obamacare also ignored and continues to ignore the problems within the US health care system caused by tort law and lawsuits, by cross-border problems of care; and by those millions of illegals who use the Emergency Care at hospitals for their ‘free’ health care.

What Obama has done, for purely political reasons, and everything Obama does is for his own hold on power and never for America, is to destroy a strong healthcare system – and ignore and refuse to deal with the problems that it did have: high legal insurance costs for doctors vs lawsuits; cross-state insurance; and, the illegals.

Why on earth should a healthy young person pay an exhorbitant amount in ‘health insurance’ when he doesn’t need most of its services and when the extortion of those high deductibles means that he doesn’t get any benefit from that policy? Why should other people be taxed, to pay for subsidies for some – with rules that are illogical and unworkable? It’s a disaster and is destroying what was one a strong and workable system.

ETAB on December 3, 2013 at 4:24 PM

@ETAB: You don’t say where you’re from in Canada. I’m from BC, where all surgeries, even emergency heart surgeries, have very long wait lists. You can say they don’t, but your saying so doesn’t change the fact that people here die every day waiting for “emergency” surgery. I waited 9 months for my emergency surgery.

Regarding “doctor lotteries”:

Article 1: “A year and a half ago, Edmonton family physician Allen Ausford was buried beneath an unmanageably large patient roster of 2,100, working 14-hour days. He elected to hold a lottery to pick 500 patients to dismiss from his practice.” Parkhurst Exchange, Montreal, 2009

Article 2: “It will be the luck of the draw that determines who gets in to the new family clinic in Yarmouth (NS). The Ocean View Family Practice is scheduled to open in March with three family doctors and one mentoring physician. It won’t be a walk-in clinic; patients will have to win a random draw.

(…)

Each application will be assigned a number, then a computer program will randomly select the winners.” CBC, 2006

It is a long standing fact that Canadian doctors use “lottery systems” to gain and lose patients. And again, you saying it isn’t so, doesn’t make it not so.

Regarding medical premium payments:

Every province handles basic medical premium payments differently, and then people can have employer benefits on top of basic government care. And some specialists, like dermatologists, opt-out of the government system, so patients must pay for service out-of-pocket, or not see the specialist.

Also, every province must follow Health Canada guidelines for basic patient care as laid out in the Canada Health Act. How the provinces implement the care is up to each, but they must implement it.

And: “The federal government directly administers health to groups such as the military, and inmates of federal prisons.” Wikipedia, Health Care in Canada

The comment section is not the place to discuss something so variable. But do Google.

lili on December 4, 2013 at 7:45 AM

I’m from BC, where all surgeries, even emergency heart surgeries, have very long wait lists. You can say they don’t, but your saying so doesn’t change the fact that people here die every day waiting for “emergency” surgery. I waited 9 months for my emergency surgery.

lili on December 4, 2013 at 7:45 AM

I’m a single-payer refugee from British Columbia (the origin of my “DB” handle) and confirm the accuracy of your comments. I could provide copious examples from the experiences of family, friends, and others.

While all could be dismissed as “anecdotal,” I have worried much more about timely access to treatment for my Canadian children and grandchildren than I do for those living in the U.S. – at least until the specter of Obamacare raised its ugly head.

I’ve recently encountered two different individuals, one at a party and one on a cruise ship, spouting the progressive talking point that “what we really need is single-payer.”

Yes, let’s just expand the VA program to everybody in the U.S. That sounds inviting, doesn’t it?

Let’s also keep in mind that the entire estimated population of BC is a bit over 4 1/2 million and the entire population of Canada is less than California’s.

Big government here is a heck of a lot bigger, more intrusive, less efficient, and arguably more corrupted than than that of a country with about one tenth the population.

Drained Brain on December 4, 2013 at 9:45 AM

lili and Drained Brain – your experiences are, as you admit, anecdotal and are not the norm. No valid conclusions can be made from individual anecdotes; valid analysis needs a large data base.

lili, a wait of nine months is not definable as ‘emergency’; it could be a serious issue but not an emergency. You would not live for nine months in an ‘emergency state’.

Nor is it a ‘long-standing fact’ that all or most Canadian doctors use a lottery method to accept patients. Because you know of two does not, empirically, move such a practice into normative practice.

All dermatologists are funded within the government system. If you mean ‘cosmetic dermatologists’, who do cosmetic treatments, they are not funded within the medical care system…because these practices are cosmetic choices and not medical issues.

The strength of the Canadian health care system is its funding within tax revenue – and this revenue can come from any source, even from the HST (the value tax in Canada). The US lacks a value tax which means that the burden of taxation is on middle and high income and corporations (the latter thus lose their fiscal capacity for Investing in larger businesses and more jobs). And, two more strengths are the decentralization of its administration – and the reduction of the levels of bureaucracy.

The weakness of the Canadian system are its refusal to allow private health care clinics, which would take much of the wait time burden off of the regular system. This is gradually changing, with the Quebec example of the courts ruling that not allowing private clinics is ‘unconstitutional’. I suspect with the implosion of the US health care under Obama, we will see more of these private clinics in Canada – for wait times were reduced in Canada by people making use of US medical care.

Obama care is an operational and infrastructural disaster. Its funding must support two administrative levels; that of the insurance companies and that of the federal government. How much is left for funding actual medical care? Because of this, the deductible range is extremely high, where you end up paying thousands for health care every year, but your $6,000 deductible means that you must pay this as well, before getting anything back from the thousands you’ve already paid in insurance. And, with more and more doctors opting out of Medicare and Medicaid, and young people refusing to purchase Obamacare – it’s a mess.

ETAB on December 4, 2013 at 1:32 PM

Your all over the map etab. One minute you’re praising Canada’s system, the next you’re vilifying obozocare.

You also change the goal posts when you feel like it, a la the change from “doctors” to “doctors in rural areas”.

The evidence of inefficiencies in the Canadian system is not anecdotal. It’s real.

KMC1 on December 4, 2013 at 3:27 PM

@ETAB: By “dermatologist” I mean “licensed dermatologists,” as in: “Chapman acknowledged the situation has come up in other provinces, including British Columbia where he said two dermatologists opted out in a dispute over fees.” CBC, Nov. 28. 2012

You’re talking out your a** now, ETAB. Sit down now.

lili on December 4, 2013 at 3:35 PM

KMC1 – you aren’t making any sense.

Praising the positive aspects of one system (eg, Canada’s healthcare system), while noting that same system’s problems (refusal to accept private care)…and also criticizing the problems of an entirely different system, Obamacare is hardly ‘all over the map’. The analyses and critiques of both systems are based on facts and thus are valid.

No, I’m not ‘changing the goalposts’; I’m clarifying what I meant, ie, that it is more difficult to get a doctor in rural areas than in urban areas. But that’s hardly a problem confined to Canada but is found in all nations.

Furthermore, an anecdotal report is, of course, ‘real’. Whoever suggested that an anecotal example isn’t real or didn’t happen?! But it remains statistically irrelevant because it is only one or two or ten situations- and that is not enough, statistically, to have any empirical validity.

Again, the situation is a comparison of the operating infrastructure of two healthcare systems, A and B (eg Canada and US) and examining their infrastructure of operation, their methods of funding, their capacity to provide robust services.

I think the pre-Obamacare system had many problems (required tort reform which the govt wouldn’t touch; cross-state flexibility; low cost medical clinics etc)…but..it worked very well for a large majority – as it did your you (my apologies about ‘moving 20 times’). The Obamacare system is a disastrous infrastructure, funding mechanism and service provider. The Canadian system has many strong infrastructural aspects but requires enabling private medical clinics and a focus on more services in rural areas.

Now, do you want to analyze the strengths and problems of all three systems? Or just express your own experiences and define them as indicative of the whole population?

ETAB on December 4, 2013 at 3:50 PM

lili – ‘opted out of what??? Dispute over what fees? Was it a private clinic?

A dermatologist, in Canada, is a medical doctor, who has gone on to take specialized courses in dermatology. Therefore, their services are paid by the public health care ‘insurance’ system of Canada.

Now, if they were working in a clinic they might have added fees not paid by the government healthcare – such as charges for prescriptions over the phone, charges for references for jobs, camps, insurance, etc. Was this the situation?

Chapman was talking about Nova Scotia, which was preventing the public from paying for medical services not covered by HealthCare. But the article also says that “Physicians have never opted out of the insured services program in Nova Scotia. We believe physicians and their patients are better served inside the insured services program,” . Got that?

Now, IF doctors choose to work in a private health care clinic, then, their services would not be covered by the government healthcare. Obviously. So, IF a doctor is in a private clinic, then, you choose to pay them directly. Your choice. So, what’s your criticism of this?

Your brief quote from the CBC contains no data, no facts, no evidence. Therefore, what is your concern? I also suggest that you stick to the issues rather than moving into personal insults.

Again,

ETAB on December 4, 2013 at 4:17 PM

Meanwhile, within the past few years leprosy, tuberculosis, hepatitis, Chagas disease, and neurocysticercosis (which is caused by the parasite Taenia solium a highly transmitable tapeworm through poor sanitary habits) and even malaria have jumped over our borders from Mexico and other nations as illegal aliens made their way into the US.

This is a consequence of a still open southern border and Obama administration policies allowing illegals to remain in this country even though they avoided the medical screenings that are required of legal immigrants prior to their being granted access to the US.

in_awe on December 4, 2013 at 4:40 PM

Wow, doctors in rural areas are hardy to find. I am shocked. Shocked I tell you.

And what about the quota system which can have you waiting more than half a year for surgery / treatment???

So now you’ve decided foe me what constitutes an acceptable period of delay in my treatment??

What about those hospitals which simply cannot get to you in time, forcing Canadians to flee to the U.S. Where they have been able to purchase those needed services???

These same issues are going to happen under obozocare, which you vilify.

Yes, that constitutes being all over the map.

KMC1 on December 4, 2013 at 6:36 PM

I didn’t insult you. I stated a fact as I saw it. And now I’m restating that fact because I’m still seeing it. Lol. Relax.

lili on December 4, 2013 at 7:46 PM

After all, Kathleen Sebelius “feels like” Healthcare.gov is secure.

All federal civilian employees should be required to get insurance through the Obamacare website. No exceptions.

malclave on December 4, 2013 at 7:49 PM

As an American residing temporarily in Canada – - Newfoundland, to be exact – - I have to say that I have not been impressed with my encounters with the medical system. Finding a doctor willing to take on new patients was a feat, and getting a quick appointment, even as an established patient, has thus far been out of the question. Trips to the walk-in clinic, then, for simple stuff like sinus infections have been crap shoots, reminding me more of military sick call – - you hope you get the “good” doc on duty, and inevitably don’t. And, given the withholding rate we’re paying? Not amused. =/

ScaryBiscuits on December 5, 2013 at 12:03 AM

And, given the withholding rate we’re paying? Not amused. =/

ScaryBiscuits on December 5, 2013 at 12:03 AM

But…but… people say Canada has free universal healthcare. /s

Consider that in 2009, for example, the disposable income of Americans averaged 29.3% higher than that of Canadians.

As of May 2013, the U.S. still had the highest disposable income of any developed country.

Obama is intent on “fixing” that, as witness his most recent pathetic attempt to change subject from Obamacare to pivot to “income inequality,” the left’s code words for confiscation.

Drained Brain on December 5, 2013 at 8:21 AM

Drained Brain and Scary Bisquits – there is no such thing as ‘free’ health care or any other service.

With regard to disposable income, I don’t see the relevance to the discussion of benefits and problems between two health care systems, for you cannot claim, without evidence, that only one variable (healthcare costs) is the cause of high or low disposable income. After all, in the US, health care is paid WITHIN the disposable income rather than within taxes. There are other variables that lead to lower cost-of-living costs in the US: lower heat, gas, hydro; lower food, clothing, and other costs. More people not paying income tax. No value tax. Oh, and Canada is not 16 trillion in debt.

lili- insults are opinions and are not facts. Kindly check out the difference.

KMC1- there is no ‘quota system’ in Canadian surgery; there are free or not free hospital beds and operating rooms and doctors. Medical care is not the same as purchasing a product in a department store. And no, I’m not making the decision on an acceptable waiting time for your surgery; I’m stating that you alone can’t define that time.

Scary Bisquits – one individual’s anecdotal experience doesn’t, empirically, prove anything; you must be aware of that! After all, I could come up with both positive and also negative anecdotal experiences that reject and also support your personal opinion! But so what? The focus has to be on the statistical average.

There are good and bad doctors in all nations; good and bad clinics everywhere. The funding mechanism doesn’t determine the nature of the doctor!

The benefits of the Canadian system are its decentralization, its focus on preventative rather than just risk care. My criticism of the Canadian system, with its wait times, is that it is still, in large part, rejecting private health care – which would greatly relieve the wait times for surgery etc. In most areas, people can see their personal doctor within the week, and in emergency cases, the same day.

In the US, the insurance-run system was, for the majority, working well; the problems were the use by the uninsured, specifically illegals, of emergency hospitals as everyday medical clinics;, the problem of massive tort insurance; the problem of state-closed insurance policies. Obamacare has not dealt with any of these and its high deductible policies mean that the focus is on risk-coverage rather than preventative care.

There can be no comparison of Obamacare with the Canadian system. The Canadian system is funded by taxes; there is no costly mediation administration of the insurance companies which must make a profit and must support their employees. And, there are no deductibles in Canada (payable out of that disposable income!), no co-payments. This means that the Obamacare system is more costly and also, doesn’t function within preventative care but only with risk…and the Canadian system doesn’t harm small businesses. businesses.

ETAB on December 5, 2013 at 8:58 AM

Drained Brain and Scary Bisquits – there is no such thing as ‘free’ health care or any other service.

Yet even many Canadians boast of their “free” health care. That was my point. That’s why I placed the word within quotation marks. That’s why I attached to the comment a sign indicating I was being sarcastic.

You either don’t recognize that some individuals like to think they are getting “free stuff” from the government, whether it be Obamaphones or Obamacare… or?

With regard to disposable income, I don’t see the relevance to the discussion of benefits and problems between two health care systems, for you cannot claim, without evidence, that only one variable (healthcare costs) is the cause of high or low disposable income. After all, in the US, health care is paid WITHIN the disposable income rather than within taxes. There are other variables that lead to lower cost-of-living costs in the US: lower heat, gas, hydro; lower food, clothing, and other costs. More people not paying income tax. No value tax. Oh, and Canada is not 16 trillion in debt.

Yes, I was there when Chretien and Martin started the cuts necessitated by years of profligate spending largely undertaken by Liberal governments.

You’re trying to make the case that the “Canadian healthcare system” is a fine approach, if only could be tweaked a little by allowing private services.

I’m with another expat, Mark Steyn, who has stated repeatedly that the imposition of a governmental or quasi-governmental system of medical care will be about the last straw in changing the relationship between the citizen and the state. You come across as a social democrat with a much different view of the world.

The funding mechanism doesn’t determine the nature of the doctor!

Actually it can and it also can influence the relationship between the provider and the consumer.

The benefits of the Canadian system are its decentralization, its focus on preventative rather than just risk care.

When the doctors negotiate fees with the provincial government, I suppose you can argue it’s less centralized than if it were undertaken on a national scale.

I have a Canadian relative who paid for his own colonoscopy at a private clinic (yes, they are finally slipping in) because the provincial medical plan would not cover it as “preventive” care, only for those exhibiting obvious symptoms, e.g. rectal bleeding.

There can be no comparison of Obamacare with the Canadian system. The Canadian system is funded by taxes; there is no costly mediation administration of the insurance companies which must make a profit and must support their employees. And, there are no deductibles in Canada (payable out of that disposable income!), no co-payments.

Ah, the dreaded idea of “profit.” With due respect, you’re coming up with the same rather dated arguments used by the vested interests in the Harvard School of Public Health.

Drained Brain on December 5, 2013 at 9:33 AM

Drained Brain – I wrote a long answer but I think I clicked on..whatever, and lost it, so, will try for a shorter response.

First, I’m not a social democrat (gasp, choke!); I’m a conservative and capitalist and strongly in favour of profit and wealth production (how else does an economy operate in its three phases of Investment, production, Consumption?). I’m a fan of Hayek and Friedman.

And I remember those two, Chretien and Martin, both reprehensible, who fobbed off costs to the provinces and boasted about cutting federal costs. Cheap political and crooked tricks.

I agree with Mark Steyn (I usually do agree with him!)but that’s not the point. I’m comparing the Obamacare system to the Canadian system. Prior to Obamacare, I favoured the US health care method, which was privately run, and in the control of the individual. But with Obamacare’s introduction, I’d have to say that the Canadian system is better. Why?

First, Obama has set up two administrative levels; that of the insurance companies which remain private and must make a profit and that of the govt administration (IRS). That’s a huge increase in costs which are born by the taxpayer and/or the individual. And, these costs will reduce the quality and capacity of health care.

The young individual who previously had no insurance (not because, as Obama’s apocalpytic rhetoric thundered) because it was too costly but because he didn’t want or need it)…now must purchase insurance but, with the high deductibles (eg $6,000) he rarely gets to use that insurance because he has to pay over 6,000 to access it! So, the health costs to the individual increase. Without health care results.

Then, the fact that many of the programs (Medicare and Medicaid) are not funded out of personal contributions and their use is increasing means a higher tax burden on those who do pay taxes.

As for those, primarily illegals, who used the Emergency Care at hospitals for their health care clinics, Obamacare won’t change a thing, because they will still continue not to pay for healthcare (they’ll all get subsidies) and the costs will be born, as before, by the taxpayer.

So, cost-wise, Obamacare is disastrous. And, with more and more doctors opting out – the health care provisions are disastrous.

As I said, prior to Obamacare, I favoured the US system because I consider that privately run systems are almost always better than govt systems. But now, I’d have to say that the Canadian system is better because Obamacare is structurally and financially, a disaster.

ETAB on December 5, 2013 at 10:33 AM

As I said, prior to Obamacare, I favoured the US system because I consider that privately run systems are almost always better than govt systems. But now, I’d have to say that the Canadian system is better because Obamacare is structurally and financially, a disaster.

ETAB on December 5, 2013 at 10:33 AM

Your latest comments are worthy of a response. I have no interest in debating the merits of the Canadian system with Dippers (members of the socialist New Democratic Party), and I’m relieved you’re not pushing their party line.

I came to realize after migrating to the U.S. that, contrary to what one reads and hears about U.S. health care in foreign parts, an essential impediment is not too little government involvement but too much, e.g. Medicare, Medicaid, insurance jurisdictions forbidding out-of-state transactions, protection of ambulance-chasing lawyers.

I think even Mark Steyn might agree that layering Obamacare on top of everything else will do nothing but harm. To that extent you and I agree.

As I wrote above, in recent casual interactions caused by all of the Obamacare news (one of the trivia teams on a recent transatlantic cruise gave themselves the name “Unaffordable Care Act” to much applause) I have had reasonable looking people opine to me that “single payer” will solve our problems.

I will continue to resist that and to resist any further incursions of the government into health care. If, push comes to shove, that’s what you’re advocating, I strongly disagree.

If, on the other hand, you’d like to see the abolition of Obamacare and some serious attention paid to reforms that could work and result in less governmental intrusion, we have grounds for discussion.

Drained Brain on December 5, 2013 at 11:00 AM

Walter Russell Mead’s blog post reinforces the point that Obamacare is making things worse rather than better, as if we didn’t know…

US Healthcare, Now With Smaller Networks Than Ever

From the end of his comments:

More and more we’re seeing that the ACA is doing nothing to reverse the worst trends driving our health care crisis— and that in some cases it’s even intensifying them. Hospitals are getting bigger, prices are going up, the system is getting even more complicated, and networks are getting smaller. Meanwhile, politicians continue to debate reforms that largely fail to address any of these problems.

Again, Canadian-style “single payer” is definitely not the solution.

Drained Brain on December 5, 2013 at 11:36 AM

Oh, and here’s another way in which Obama and the Dems will almost surely try to emulate Canada, as described in a column by Kevin Williamson at NRO:

Drafting Docs
Look for doctors to be conscripted to treat Medicare and Medicaid patients.

It include a link to a 2006 NYT piece profiling Dr. Brian Day and his Cambie Surgery Centre in Vancouver:

As Canada’s Slow-Motion Public Health System Falters, Private Medical Care Is Surging

Drained Brain on December 5, 2013 at 11:53 AM

Drained Brain – no, I’m not advocating a single-payer government run system for the US – or any country. I’m a conservative and capitalist and therefore, I consider that a robust economy, which provides services to the people, is best run within a private market-based infrastructure. As I said, I was comparing the Obamacare govt-run system and the Canadian govt-run system, and, as such a comparison, the Canadian is better.

I simply can’t get my head around how anyone with any fiscal ability could set up a two-tiered administrative level (the private insurance companies AND the govt IRS) to run the same program. The sheer double administrative costs, never mind informational networking, renders it fiscally and operationally a disaster.

And to set up a ‘faux-tax’ system where the individual has to pay for ‘insurance’ which he rarely gets to use because his deductibles are so high- that too doubles the cost of health care for the consumer. Do they think that the economy can handle this?

I agree with you that reforming the ‘old’ private US system is best, by dealing with the high costs to doctors against being sued, the role of litigation and lawyers, the not-crossing state lines, and, the costs of the ‘illegals’ who use and will continue to use, the hospital emergency rooms as their daily medical clinics. But ALL of these issues – all of them – the Obama gang has refused to deal with any of them.

ETAB on December 5, 2013 at 11:56 AM

What is interesting, Drained Brain, is that more and more private clinics are opening up in Canada, to relieve the wait times in the government run medical care systems. A longstanding method of relieving wait times for treatment has been for those people who could afford it, to go to the US for treatment.

I suspect that even more private Canadian clinics will open up IF Obamacare is allowed to continue on in the US, for the result of Obamacare will be fewer hospitals, doctors and clinics willing to treat people.

Since I’m coming to the conclusion that Obamacare has nothing to do with health care, for by every analysis, it will reduce health care services to Americans, then, its agenda was and remains, purely political.

Obama is psychologically, unconnected to reality; he lives in his own virtual world-of-words. He seems to think that all he has to do is say something, and it exists; that’s why all he ever does is campaign and is unable to deal with real factual situations in the world.

I suspect that Obama’s health care campaign was for votes; he himself never bothered to deal with the operational development of the plan. And now that it’s so disastrous, I suspect that he will distance himself and try to ignore it – again, Obama can’t deal with reality. If His Words can’t make something happen, he leaves the room. It’s up to the GOP to come up with specific, simple, remedies. Not words, but actual remedies.

ETAB on December 5, 2013 at 12:11 PM

ETAB, as a former policy analyst, I am quite aware thst “anecdotal experiences” are far from the statistical data usually considered. Still, the cold, hard math cannot tell the entire story, nor can it explain totally perspective and decision-making processes; the human experience is a non-quantifiable factor that cannot be overlooked. In my case, as someone who has never specialized in healthcare policy, my anecdotal experience — with both the Canadian system and military medicine – - has led me to do more research and cemented my belief that socialized systems might work for other countries with smaller populations, but civilian application is contrary to the ideals the US was founded upon.

I also recognize that the experiences in other, more populated areas like Toronto or Vancouver might be different. But, for my money, I would rather have the freedom to choose my doctor, and be able to pay out of pocket for better care, if I wish or am able to do so. The Canadian system, in my experience, has removed the ability to choose – - and that is something that cannot be assigned a statistical value.

ScaryBiscuits on December 5, 2013 at 2:54 PM

Scary Bisquits – I agree with you in your rejection of socialized medicine and your support for freedom of choice (eg, of medical insurance policy). Again, to repeat, my critique was of Obamacare vs the Canadian system. Obamacare is a grossly distorted almost corrupt method of socialized medicine, while the Canadian system is, as you say, a fully socialized system.

Socialized medicine in Canada does not mean that you don’t get to choose your doctor! There is absolutely no evidence of that and I am stunned that you even suggest it; of course you choose your own personal care doctor. If you want to accept anecdotal evidence, I’ve never heard of any situation where people don’t choose their doctor…except in drop-in clinics. But it does mean that you aren’t allowed to pay out of pocket for ‘better care’ -an amorphous statement that would be rejected by most doctors of any integrity. It means that you can’t pay out of pocket for faster service; that’s certain.

ETAB on December 5, 2013 at 3:28 PM

If you want to accept anecdotal evidence, I’ve never heard of any situation where people don’t choose their doctor…except in drop-in clinics. But it does mean that you aren’t allowed to pay out of pocket for ‘better care’ -an amorphous statement that would be rejected by most doctors of any integrity. It means that you can’t pay out of pocket for faster service; that’s certain.

ETAB on December 5, 2013 at 3:28 PM

I presume you’re referring to the GPs, general practitioners who serve as the gatekeepers for the system.

Some, unlike you, may not know that a patient may not make an appointment with a specialist without first having it approved by the referring GP.

My small town Canadian GP told me the last time I visited him that he was spending more and more time on the phone trying to find specialists who could fit in his patients in any kind of timely manner.

My family at most might have a choice of two specialists, with little information available other than the GP’s opinion as to their knowledge, capabilities, and general “fit.”

Then there was the question of whether to wait for a possibly superior doctor or consult the more available specialist weeks or months sooner.

In our small town it was quite easy to get in to see your GP if you had a runny nose – even though it wasn’t uncommon to sit in the waiting room for 90 minutes – but much more challenging to see a specialist.

I have a lot more anecdotal information but I’ll spare you the details.

Drained Brain on December 5, 2013 at 3:56 PM

Drained Brain – yes, that IS the case; in Canada, you can’t get an appointment with a specialist unless your GP has first examined you and suggested that your treatment requires a specialist. I, frankly, have absolutely no problem with that and think that it makes medical sense.

And yes, I do trust my GP to select a specialist who will ‘fit’ with me. I also admit that I don’t have the skills to differentiate between who is a ‘possibly superior doctor’.

Yes, I can understand sitting in the waiting room of a GP for 90 minutes (though a half hour is the norm in my experience); I accept that because I know the GP is thorough, chatty, friendly, doesn’t treat me like a machine.

ETAB on December 5, 2013 at 4:11 PM

Drained Brain – yes, that IS the case; in Canada, you can’t get an appointment with a specialist unless your GP has first examined you and suggested that your treatment requires a specialist. I, frankly, have absolutely no problem with that and think that it makes medical sense.

And yes, I do trust my GP to select a specialist who will ‘fit’ with me. I also admit that I don’t have the skills to differentiate between who is a ‘possibly superior doctor’.

Yes, I can understand sitting in the waiting room of a GP for 90 minutes (though a half hour is the norm in my experience); I accept that because I know the GP is thorough, chatty, friendly, doesn’t treat me like a machine.

ETAB on December 5, 2013 at 4:11 PM

You’re perhaps missing my anecdotal point. My GP himself had little choice of specialists to whom he could refer his patients, despite living and working within an hour of Vancouver, the third largest metropolitan area in the country, as you know.

In the U.S. there are various ways to get ratings of doctors and of hospitals. In Washington State there’s an annual issue of one of the regional magazines rating doctors.

No, my time was worth something to me, so having to sit for extended periods of time while sometimes harried doctors churned patients through to meet their office overhead was annoying.

Years ago I read that the kinds of waits we often endured were considered a breach of ethics by the AMA or some similar US group of doctors.

Drained Brain on December 5, 2013 at 4:17 PM

ETAB, have you lived extensively in both countries, as I have?

I always used to say in Canada that “everybody’s in the charity ward.”

There’s an whole different attitude in doctor’s offices and in hospitals between Canada and the U.S.

Here, until Obama “fixes” it, I’m a valued customer. In Canada, I was a supplicant.

Drained Brain on December 5, 2013 at 4:19 PM

Well, Drained Brain, we’ll simply have to disagree. I won’t give anecdotal experience other than to say that in Canada, my GP and specialists were all top notch in their fields, and treated me, not as a ‘supplicant’ (whatever you mean by that) nor even as a customer, but as a valued person and even, yes, a fellow-person, in the reality that is life.

I’m sceptical of ratings of doctors – and professors – (and I am one); they don’t tell the full story, nor whether or not you and that person will get along. I certainly know anecdotes where people have left their doctors out of almost mutual dislike, and other stories where the bond between them is deep and respectful.

Again, I don’t mind waiting the half hour; I don’t consider it has a thing to do with ethics. I’m not a part on an assembly line nor is anyone else and if someone takes a bit of ‘chat-time’, it doesn’t bother me. My own doctor is very chatty and sometimes has to be reminded, that, ah, I’m there for a medical reason and chat about our mutual families or the latest shows…must wait. Doesn’t bother me if the same warmth is extended to other patients.

ETAB on December 5, 2013 at 4:50 PM

Well, Drained Brain, we’ll simply have to disagree.

Yes we will if you truly believe all GPs and specialists are top-notch in Canada or in any other country in the world. Sorry but one more little anecdote: For one child with a chronic problem we encountered over a period of years two dud specialists and eventually lucked onto a terrific one, simply because our replacement GP had been one of his students in UBC’s medical school.

You are truly viewing the Canadian medical landscape through rose-coloured glasses.

I’ve known others who call themselves conservative and have the same opinion though. Of course, if you live in Canada that’s the situation and you might as well embrace it until more of that “creeping privatization” sneaks past the hospital employees’ union and other special interest groups.

Stay healthy.

Drained Brain on December 5, 2013 at 5:08 PM

Drained Brain- I’m a realist not someone living on a cloud. Therefore, I cannot, ever, conclude that ALL GPs and specialists are top-notch in Canada or any country. Therefore, I am free to choose, and stay or leave my GP. And also, tell my GP who has referred me to a specialist, if I’m not satisfied.

I won’t go into anecdotes but I sure have encountered real idiots and dud GPs and specialists; we all have.

I don’t know if private health care clinics are being held back by hospital unions. I’m very, very, very opposed to public service or indeed, any unions, by the way. I think that the utopian idealism of the brainwashed Canadian public of that nefarious ‘Tommy Douglas’ who set up the health care system..and the NDP and Liberal political parties who feed off that rubbish, is what is holding back privatization of medical services. It will come.

The key problem now is the destruction of America by Obama.

ETAB on December 5, 2013 at 5:54 PM

I’m a realist not someone living on a cloud…

I don’t know if private health care clinics are being held back by hospital unions.

Really?!?

Professor, you need to get out of your ivory tower more often.

Start by doing a search of Canada + “creeping privatization,” the phrase used quite deliberately above.

Be well.

Drained Brain on December 5, 2013 at 5:58 PM

The Canadian system is irrelevant. They don’t have the gigantic and permanent underclass that we have in the US.

I don’t have the exact quote, but when Milton Friedman was discussing economics with a Swedish colleague. The man argued that Sweden didn’t have the levels or depths of poverty that are seen in parts of the US. Friedman responded by noting that the US doesn’t have that kind of poverty… among Swedes here.

Much of our problem is a permanent dependent class. It’s cultural and will take generations to cure, if at all possible.

mankai on December 5, 2013 at 10:27 PM

The Canadian system is irrelevant. They don’t have the gigantic and permanent underclass that we have in the US.

I take it you’ve never visited a Canadian “First Nations” reserve.

I don’t have the exact quote, but when Milton Friedman was discussing economics with a Swedish colleague. The man argued that Sweden didn’t have the levels or depths of poverty that are seen in parts of the US. Friedman responded by noting that the US doesn’t have that kind of poverty… among Swedes here.

Much of our problem is a permanent dependent class. It’s cultural and will take generations to cure, if at all possible.

mankai on December 5, 2013 at 10:27 PM

Obama is pushing punitive liberalism, in the words of Mark Steyn, on the U.S. The progressives want everybody to be members of a “permanent dependent class” and Obamacare is one of its foundational acts. It’s a feature, not a bug.

Drained Brain on December 5, 2013 at 10:40 PM

The “progressives” are champing at the bit, with the leftwing Washington State Congressman McDermott almost literally rubbing his hands together in glee:

How to Revive the Fight for Single-Payer

Drained Brain on December 6, 2013 at 8:38 AM

Canada and America systems…..

Apples and “for profit” Oranges.

BL@KBIRD on December 6, 2013 at 11:06 AM