From: gld@cunixb.cc.columbia.edu (Gary L Dare)
Subject: Re: Canadian vs US health care (was "ACM downgrades Catastrophe Medical Insurance")
Reply-To: gld@cunixb.cc.columbia.edu (Gary L Dare)
Organization: The Bates Motel
Date: Fri, 2 Oct 1992 17:25:19 GMT

In article <BvGnI1.FKB.1@cs.cmu.edu> clamen+@CS.CMU.EDU writes:
>
>I had the opportunity to speak with an old friend of mine while we
>were both home in Montreal earlier this week.  He's a neuro-surgery
>resident in T.O., on rotation at Sick Kids this season...
>
>He says that the Buffalo MRI site advertises heavily in Toronto, and
>gets patients.  However, he has had to order new MRIs for many people,
>owing to the poor quality of the results delivered from Buffalo.

Wait!  I remember this place ... it's advertised in the doctors' own
papers and stuff (e.g., College of Physicians and Surgeons bulletin)
that my friend in suburban Toronto showed me once.  Like a lot of U.S.
facilities, they sit idle a lot of the time and are looking for ways
to generate more income, so Southern Ontarians who live away from T.O.
and Hamilton would find it more convenient to get to Buffalo and spend
their health insurance benefits there (yes, OHIP pays out to US border
sites closer to rural customers, and those places accept their Ontario
fees schedule).  This is purposefully designed in, because:

1. As I've stated in previous notes, our doctors are all private and
invest in their own practices.  Canadian doctors are more conservative
and less entrepreneurial then American ones, and despite almost the
same net take-home pay (lower gross due to less malpractice, etc.)
they will take time off and travel (like my friend, the sailor) rather
than sink money in technology especially in outlying areas (we don't
have anything like sprawling suburbs except for a ring around Toronto).

2. Certain provisions were built into the Canadian Health Act under
the vision of the late Paul Martin, Sr. of the Liberals (not as in
liberals (-;) which seem to be there to *prevent* any socialized
medicine from emerging (e.g., a hard-left New Democratic Party faction
wins a provincial election and wants to make a health plan more like
an HMO and less like pure health insurance; this could have happened
with the David Barett government in British Columbia of the early 70s
but they didn't last long).  As per Consumers Reports, if a province
buys a piece of technology then they're responsible for maintenance
costs, too.  In practice, that has preserved the market beyond the way
we do health insurance because the government does not provide any
health care; but in some instances, they've bitten the bullet to buy
an MRI due to private doctors' inaction, unsuccessful fund drives by
private and hospital philanthropies, and/or low population count. So
the Ontarians can get away with using an American MRI someone else
invested into, they and their insurance are taking advantage of it.

Idle American facilities taking Canadian health insurance at the
domestic rate is not uncommon.  In Florida, a favourite sunning spot
for Quebecois, hospitals and clinics in and near "Little Montreal" are
taking Quebec retirees and tourists at La Regie de L'Assurance Sante's
fee schedule because they have excess capacity for paying customers.
In effect, La Regie's money is helping to pay for uninsured Americans
piled up in Emergency wards out back of the same hospitals ... (source:
La Presse, Montreal's largest French daily, mid-January)

>There are also a lot of irrelevent MRIs taken.

Sorry to hear that our doctors abuse them like the Americans ...
keeping up with the Joneses, perhaps? (-;

gld
--
~~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare				
> gld@cunixB.cc.columbia.EDU		Oct 26/92: Just say "OUI!"
> gld@cunixc.BITNET			(Let's worry about the economy!)
Newsgroups: talk.politics.misc