dems have been successful in creating a more widespread feeling of healthcare as a "right".

Definitely. That's why it has to be "repeal and replace," and not just "repeal." But even so, I think a proposal like Paul's could be sold to the general public, and could certainly gain the support of Republican voters.

I think the polarization is what will sink Trump, and that the dems are going to try to keep that solid wall of "resistance" no matter how good anything Trump and the pubs proffer.

Also definitely. I think there's zero chance of the Democrats working with Trump on anything. They all consider themselves part of the antifa resistance.

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

Canada is ranked something like 29th in the world by the WHO so we've got nothing to be smug about either. We both should be looking at the countries that are at the top of the list for inspiration.

You guys north of the border are prone to get unjustifiably smug about your system.

I'm not smug with it at all. Our system is fine for basic things but that's it. I had a bike accident and recovered in a hospital in Bend. A few months later, had to have a "simple" arthroscopic surgery on my knee (torn ligament). Here, they said I had to have an ultrasound before I could schedule surgery and there was a 6-month waiting list. A friend works as a P.A in North Carolina so I flew down there. They have a clinic (not a full hospital) and the doctor said you don't really need an ultrasound because the problem was obvious. He said he could just operate and I agreed. The next day I had the operation and walked out with a crutch the next day. I had a world-wide health insurance policy from my bicycle trip so was covered and I paid $1,500/year for that policy. It's not available if you live in Canada or the U.S., but was available if you travel.

People here like to say our system is great but it's not, we have the same problems as everyone else. The procedures are expensive, the population is ageing and getting less healthy and everyone feels they have an inherent right to "free" healthcare. People here who think everything is rosy are not paying attention.

Just to clarify. A canadian could buy that policy and travel to the us for an elective procedure and it was covered? If so That is hysterical......

We have world wide cover but i am pretty sure it only covers emergency and gp visits. Not planned elective non essential surgeries ;)

in some areas they are far better. for example, if you have cystic fibrosis, youll likely live a decade longer in canada than the us. they just treat it better.

https://www.google.com/...2UKq2BzVPM5AJXJ2yPbw

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who's smarter than you're? i'm!

emulate the most successful?!?! preposterous!!! usa is the best, baby!

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who's smarter than you're? i'm!

Just to clarify. A canadian could buy that policy and travel to the us for an elective procedure and it was covered? If so That is hysterical......

No the policy I had was not for Canadian residents. I am a citizen but worked overseas so was non-resident and not eligible for Canadian healthcare. It was a world-wide policy only available for people traveling. I went through 25 different countries and was covered everywhere.

We have world wide cover but i am pretty sure it only covers emergency and gp visits. Not planned elective non essential surgeries ;)

Mine wasn't a planned elective surgery. I had been in a bike accident in August 2014. In November 2014, I tore my medial collateral ligament and the doctors here in Canada and the U.S said that they were confident it was a result of the accident. I had very limited movement between the accident and the time I twisted my knee. They said that based on my right knee not showing any sign of a problem, and the fact that I did a very minor twist (I was raking leaves), that they suspected it was from my accident. It was not elective surgery.

Even if my case wasn't related to an accident, and I was a Canadian resident, the point is really the waiting time for an ultrasound. It may not be life saving surgery, but when you can barely walk and risk doing more damage, you don't want to wait 6 months for the x-ray and then have to actually book a date for surgery.

People have written books about that. I find the Canadian system does a decent job of preventive care through the family doctor and if you have something very urgent you get taken care of quite well. The in between stuff not so good. Some common sense stuff like small user fees would be a good idea. It would likely unclog the GPs office bigtime. Some mechanism of rewarding docs for cost containment would be good. When I see the number of tests that get ordered that change nothing it is quite discouraging.

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They constantly try to escape from the darkness outside and within
Dreaming of systems so perfect that no one will need to be good T.S. Eliot

...exactly....it wasn't shitty enough for the Freedom Caucus!

They've done some really dumb stuff in Ontario. De-listing chiropractic, physiotherapy and optometry when Smitherman was health minister was a move that could only be expected from a guy whose qualification for the job was running a camera store before entering politics. All that did was clog the GP's office even further with lower income people who could no longer afford these services even though they were never fully covered by OHIP. I've always thought that a small service charge would help keep the time wasters out of the GP's offices.

For many if not most musculoskeletal issues you're probably better off going to a physiotherapist or chiropractor than a GP. They're more qualified to diagnose and treat, and perhaps as important they can't give you opioids for the pain.

Wow. Just wow.

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Remember - It's important to be comfortable in your own skin... because it turns out society frowns on wearing other people's

That's very true. What's a GP going to do for these kind of conditions other than write a prescription? If you have a medical condition then go to a medical doctor, but for the most part they don't have a lot of tools in the chest for dealing with musculo-skeletal problems.

I'm pretty sure our GP's can rx opioids.

We have nurses prescribing and changing chemo doses.

We've pharmacists monitoring and rxing lots of drugs through the use of protocols

All of which goes to preventing someone from going to secondary care for it

You misunderstood, i.e. PTs and chiro's can't prescribe you opioids therefore they don't contribute to their overuse and the opioid epidemic sweeping the country.

Most GPs about all they can do for musculoskeletal pain is prescribe pain killers, order imaging tests (which can be another boondoogle) and send you on to someone who knows more.

Most GPs about all they can do for musculoskeletal pain is prescribe pain killers, order imaging tests (which can be another boondoogle) and send you on to someone who knows more.


That's my experience with GP's. They have a quick look, prescribe some form of medicine or pass you on to a specialist. I always thought the use of a P.A or Nurse Practitioner which they have in the U.S., would be far cheaper than using a GP.

I've not seen a doctor since my follow up with the Neurosurgeon after having a tumor removed over 2 years ago. My GP left town and all I can see at the practice is a Nurse Practitioner. Been trying halfheartedly to find a doc for new GP but no one is taking new patients. Welcome to rural(ish) America.

Absent of one voluntary physical, I haven't been to a GP in nearly a decade. The primary reason (besides finding a reliable one) is that I have far more insight into my own non-emergency issues than a GP ever could. I generally avoid pharmaceuticals, so if a GP is merely going to give me a once-over and refer me to a specialist, then I'll just do the work myself.

On the other hand, I think that our pediatrician (essentially a GP for kids) is a valuable asset. It's hard to know the genesis of a kid's condition, and these practices have far better insight into what kind of things are going around in the community.

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"The right to party is a battle we have fought, but we'll surrender and go Amish... NOT!" -Wayne Campbell

We actually do have nurse practitioners in Canada, just not enough of them. We have a couple in our area and I usually go there for minor ailments rather than waste my GP's time. The P.A. system in the USA should also be adapted here.

We actually do have nurse practitioners in Canada, just not enough of them. We have a couple in our area and I usually go there for minor ailments rather than waste my GP's time. The P.A. system in the USA should also be adapted here.

My niece graduated and is working as a registered nurse and is looking at continuing to become a nurse practitioner. I know one in the U.S and they are very knowledgeable and can do a lot of the work doctors do for many of the issues that come up daily. There are a lot of ways to cut medical costs and that is one but of course the Canadian Medical Association is very powerful and they will resist any attempts to infringe on their work.

There are a few PA programs in Canada now, maybe three at last count. Problem is the nursing lobby, which sees PAs as taking market share away from NPs, and in reality, that's true, but they operate on completely different models and both have carved out their niche and are utilized effectively here in the U.S..

This is also the reason why the NP higher ups are pushing for a Doctoral degree for NP. It has nothing to do with competency and scope of practice, and everything to do with trying to edge out PAs in pay scale and clout. Good luck with that, Doctor Nurse.

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The devil made me do it the first time, second time I done it on my own - W

In Ontario we have lots of NPs. My experience with them is in family health teams where they do primary care. They also work in hospitals helping out specialists in ERs seeing minor problems or compiling info for the doc in ER with very complicated patients. In primary care they have been cast as independent practitioners. They have pretty well decided they will see two patients per hour whether it be a sore throat or a new consult for depression etc. Each is compensated at about 85-100K per year. When I last worked fee for service about 8 years ago I saw 5-6 patients per hour which netted me about 200K a year and I was covering my own overhead which NPs don't do. So I don't think they are saving us much money. Patients like it though as they are not rushed. PAs have started up in Ontario I can see a power struggle between the two in the future. My understanding is most of the GPs in BC are still fee for service and their fees are no better than mine were so I would think they have to see 6 pts an hour to make a decent income. Probably 150-200K at year at that rate.

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They constantly try to escape from the darkness outside and within
Dreaming of systems so perfect that no one will need to be good T.S. Eliot