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health-care-costs-too-high-oecd

Posted: Mon Sep 13, 2010 11:21 am
by stuward
This is more political so I figure it should go here rather than in General.

http://www.thestar.com/news/canada/arti ... -high-oecd

My main concern with this is this recommendation:
Patients should be paying a small fee or a deductible for their health services, so they’re not tempted to rush to the doctor for every little sneeze, the report urges.
It seems to me that in order to keep costs down, patients should be encouraged to err on the side of caution and have small issues checked out before they become expensive conditions. In fact, total medical expenses would probably go down in the long term if an enhanced preventative medicine program was put in place. Ideally a cradle to grave wellness team including fitness, nutrition and lifestyle councelling would be included. Does this make sense to anyone?

Posted: Mon Sep 13, 2010 12:29 pm
by Rucifer
No Stuward....NOOOOO!!!! Don't you realize what you've done?! You've created another political thread! :naka: (Ironman) vs :kermit: (frogbyte)

On a more serious note, it seems something inbetween the American and Canadian system would probably be best. I just don't know what that inbetween would be

Posted: Mon Sep 13, 2010 12:37 pm
by Ironman
Rucifer wrote:No Stuward....NOOOOO!!!! Don't you realize what you've done?! You've created another political thread! :naka: (Ironman) vs :kermit: (frogbyte)

On a more serious note, it seems something inbetween the American and Canadian system would probably be best. I just don't know what that inbetween would be
:green: :laughing3: :laughing3: :laughing3:

Posted: Mon Sep 13, 2010 12:52 pm
by Ironman
I'm not sure, Stu. It might be that a small deductible will make lower income people or cheapskates think about it. It could also have the reverse effect by hampering prevention. It's hard to say.

I think basic stuff should be part of the plan, where as there should be a deductible or copay for the more expensive stuff. You don't need people getting an MRI every time they bump their heads, or anything like that. Or perhaps regulations regarding the use of such things. Like requiring one or more doctors to sign off on it.

Regulations should always give subjective decision making to doctors though. You don't need some dumb politician making medical decisions.

Posted: Mon Sep 13, 2010 1:17 pm
by stuward
Ironman wrote:... You don't need some dumb politician making medical decisions.
I think this is the key. The OECD is applying bean-counting rules to an issue that they really have no business messing with.

Posted: Tue Sep 14, 2010 4:41 am
by KPj
Apparently over here (we have the NHS), GP's time is dominated with very minor things (plus binge drinkers and stabbings). If i'm right (i may not be), that's why we have what's called "NHS 24", which is a helpline you call. You explain your symptoms to a Nurse, they ask you all sorts of questions, and she may tell you to go to a pharmacy and get some kind of med, make an app with the Doc, or get yourself off to hospital.

I've not really had much experience with it. I think I called it once. I had mumps, and was trying to figure out why my face had became all obese. After calling, they told me to go straight to a Doc at the hospital. The Doc was actually very excited to tell me I had mumps. Apparently he hadn't seen it in years.

KPj

Posted: Tue Sep 14, 2010 4:53 am
by stuward
Had you been to Eastern Canada recently? We had an outbreak of mumps a couple of years ago. It turned out the people of my generation all had it as a kid. Later ones had 2 shots and were quite immune. The younger generation only had 1 shot. Almost all the cases in this last outbreak were college age people.

http://www.ncbi.nlm.nih.gov/pubmed/16940266

I guess the UK had it just before we did. Maybe we caught it from you.

Posted: Tue Sep 14, 2010 5:01 am
by KPj
stuward wrote:Had you been to Eastern Canada recently? We had an outbreak of mumps a couple of years ago. It turned out the people of my generation all had it as a kid. Later ones had 2 shots and were quite immune. The younger generation only had 1 shot. Almost all the cases in this last outbreak were college age people.
No... It was a good 1.5 - 2 years ago I got it. It was fun. Couldn't move for around 1 week, actually got it pretty bad. I spent all day sleeping, sipping protein shakes, and drinking whisky to help me get back to sleep. A few people I know actually got it, but there wasn't really an outbreak.

KPj

Posted: Tue Sep 14, 2010 5:04 am
by stuward
KPj wrote:.... I spent all day sleeping, sipping protein shakes, and drinking whisky ....

KPj
So why was this bad?

Posted: Tue Sep 14, 2010 8:29 am
by KPj
stuward wrote:
KPj wrote:.... I spent all day sleeping, sipping protein shakes, and drinking whisky ....

KPj
So why was this bad?
It was actually great, as long as I didn't need to move :smile:

KPj

Posted: Tue Sep 14, 2010 8:47 am
by Jungledoc
I agree with everyone. I think a health-care plan should include free, or very low-cost preventive services and education/information services for minor problems. I also think that there should be some sort of copay or deductible for accessing acute care services. In my experience with privately-insured patients who had copays, they tended to come in at more appropriate times, while medicaid patients (the health care plan for the poor in the US) who (at least in my state have no copay) or people with really expensive insurance with no copay, would come in for trivial matters, or worse from a system point of view, go to the ER for every little ache and pain. ERs can't provide continuity of care, preventive services or much education (aside from a tired, frustrated ER doc yelling at them about abusing the system, a less-than-ideal educational approach).

Australia! I like health care in Australia. US and Canada could both learn from them.