How bad does health care suck in Canada?

[MikeWaters]

Originally Posted by CardiacCoug

I have had plenty of negative experiences with private billing/insurance also. But when my 3-year old son had MRSA osteomyelitis and a 103 degree fever last year I was glad he could get an immediate MRI and immediate surgery that saved his life. Houston has more MRI machines than all of Canada and an excess of operating rooms and orthopedic surgeons because medicine is profitable. When you really need it, it's good to have our system, even with all its flaws.

I'm all in favor of squeezing the insurance companies out of the picture. They are leeches on patients and doctors. Methodist Hospital is our enemy (I'm at St. Luke's) so yeah, I agree that they suck. I'm in favor of prosecuting insurance fraud and for heavy penalties on doctors and hospitals for this behavior.

As far as the VA, I think it works well for those who don't want to pay anything extra for their health care and have limited expectations. I would be OK with a two-tiered system in the U.S. -- VA-style health care for those who want to rely on the government and private health care for the rest of us. The VA is fine for some, but not good enough for me and my family. I expect a better level of care and am willing to pay for it.

VA is the best in some things. I'll let you guess what they are. Beat private hospital systems hands-down.

[myboynoah]

Originally Posted by CardiacCoug

I would be OK with a two-tiered system in the U.S. -- VA-style health care for those who want to rely on the government and private health care for the rest of us. The VA is fine for some, but not good enough for me and my family. I expect a better level of care and am willing to pay for it.

This describes the French system. If you can and are willing to pay, you can get better service than the standard that the government offers everyone.

Well, at least they still have liberté and fraternité.

[SoCalCoug]

Originally Posted by CardiacCoug

I'm not saying we get rid of charity hospitals and government funding for the poor, just that a private system serves the majority of people much better.

SoCal's response is to link a negative example from a government-owned and operated hospital in the U.S. I find that ironic.

FYI, part of my law practice is medical malpractice. I am very familiar with many examples of substandard private care - how about the lady who died when her bowels basically exploded when her doctor failed to make the easy diagnosis of a bowel obstruction. Or the private doctor who didn't adequately check for compartment syndrome after an open reduction of a leg fracture, resulting in a patient who is likely to lose his leg. I've also got the private doctor who allowed a woman to go through 48 hours of labor, with signs of distress to the baby, and now the baby is a spastic quadraplegic?

My point was, you're taking a single incident and projecting it on an entire healthcare system, in order to "prove" that the Canadian, government-run system is much worse than our mostly private-run system. If that's what you're going to do, I can give you similar examples in the U.S.

You may be right, but your "proof" is not valid.

[CardiacCoug]

Originally Posted by SoCalCoug

FYI, part of my law practice is medical malpractice. I am very familiar with many examples of substandard private care - how about the lady who died when her bowels basically exploded when her doctor failed to make the easy diagnosis of a bowel obstruction. Or the private doctor who didn't adequately check for compartment syndrome after an open reduction of a leg fracture, resulting in a patient who is likely to lose his leg. I've also got the private doctor who allowed a woman to go through 48 hours of labor, with signs of distress to the baby, and now the baby is a spastic quadraplegic?

My point was, you're taking a single incident and projecting it on an entire healthcare system, in order to "prove" that the Canadian, government-run system is much worse than our mostly private-run system. If that's what you're going to do, I can give you similar examples in the U.S.

You may be right, but your "proof" is not valid.

There will always be individual doctors who are negligent and commit malpractice. I agree that a specific act of negligence or malpractice by a physician or nurse does not prove a problem with the health care system under which that person operates.

When a woman has been diagnosed with a brain tumor that is compressing her optic nerve and she has to wait months for surgery (meanwhile having headaches and progressive loss of vision) because that is how "the system" works, that is a problem with Canada's health care system. That could never happen to an insured patient in the United States.

Our system has huge problems, but we don't have that particular problem -- namely adequately insured patients having to wait months for necessary procedures or tests.

[MikeWaters]

I had a situation come up with a friend of a friend that needed psychiatric help.

I emailed a list that contains most (or at least a lot) of local psychiatrists. I asked if there was a psychiatrist in town who takes insurance and could see a new patient within two weeks.

There was none. Good luck finding a mental healthcare if 1) you're not poor or 2) you're not rich (pay cash).

I once saw a presentation where a psychiatrist posited a question that had a lot of truth: "Do the non-poor also have the right to mental healthcare?"

Actually in a lot of cases there is mental healthcare services ONLY available to the poor, and there is nothing for the middle class and upper classes, because it is not profitable or prioritized by the private sector.

[MikeWaters]

Let me give you another example. The guy who was photographed carrying the injured Iraqi child, you committed suicide.

I read that recently he had been on an inpatient unit for 6 months.

Good luck getting 6 months of inpatient care with insurance. It's unheard of. Check your policies. The mental healthcare portion is carved out. Two weeks would be an eternity with your plans. And good luck paying cash at $1000/day.

[ERCougar]

Originally Posted by SoCalCoug

FYI, part of my law practice is medical malpractice. I am very familiar with many examples of substandard private care - how about the lady who died when her bowels basically exploded when her doctor failed to make the easy diagnosis of a bowel obstruction. Or the private doctor who didn't adequately check for compartment syndrome after an open reduction of a leg fracture, resulting in a patient who is likely to lose his leg. I've also got the private doctor who allowed a woman to go through 48 hours of labor, with signs of distress to the baby, and now the baby is a spastic quadraplegic?

Yeah, those things NEVER happen in France.

Or at least you wouldn't be getting paid for them...

"Easy diagnosis of a bowel obstruction"...I love it. Is the diagnosis of compartment syndrome easy too?

[SoCalCoug]

Originally Posted by ERCougar

Yeah, those things NEVER happen in France.

Or at least you wouldn't be getting paid for them...

"Easy diagnosis of a bowel obstruction"...I love it. Is the diagnosis of compartment syndrome easy too?

Didn't order a barium enema after prolonged complaints and repeated returns.

Diagnosis of compartment syndrome is definitely not easy when you don't even test for it, even when it's a known complication of this type of surgery.

In both cases, we have practicing doctors (in the case of the compartment syndrome, the subsequent treating physician at Loma Linda) testifying that the defendants acted below the standard of care.

[ERCougar]

Originally Posted by SoCalCoug

Didn't order a barium enema after prolonged complaints and repeated returns.

Diagnosis of compartment syndrome is definitely not easy when you don't even test for it, even when it's a known complication of this type of surgery.

In both cases, we have practicing doctors (in the case of the compartment syndrome, the subsequent treating physician at Loma Linda) testifying that the defendants acted below the standard of care.

I obviously can't argue these specifics, as I don't know the cases. I will say that the "subsequent treating physician" and his opinion doesn't mean a lot, even (especially?) if he's at Loma Linda. In medicine, we call this kind of Monday-morning quarterbacking looking with the retrospectoscope, and it's particularly annoying when it comes from an academic. I also will say that I have never ordered a barium enema to diagnose a bowel obstruction. I can't even get a BE on a weekend or night. So you're already beyond the "simple diagnosis" of bowel obstruction. Diagnosing compartment syndrome requires an extremely painful test, and you're certainly not going to subject every postop patient to it. So how do you decide who to test? "Pain out of proportion to physical findings" or in other words, every post-op patient.

I have no idea if your physicians in question were negligent; I'm just playing devil's advocate. Plus, I'm just grouchy about malpractice law. My latest experience, which I can tell you about because it's fortunately not going to court. Dude comes in after wrecking on his motorcycle. No helmet, shorts and a t-shirt, and basically lucky to have survived. Has a couple of nasty lacerations on each of his knees. I spend about an hour picking rocks out of both lacerations, then rinsing them out and sewing them up (single coverage in the ER at the time so yeah, everyone else had to wait). I tell him, "These will probably get infected--fill the prescription and complete the course of the antibiotic". I give him a shot of antibiotic in the ER just for good measure. I arrange followup for him with the orthopedist to recheck the wounds and fix his broken ankle. He skips the antibiotics, sees the orthopedist, who then has to reopen the lacerations and drain the infection, postponing his surgery for a week later.

He then takes the case to an attorney (who also does med mal on the side), and is told by the attorney that if I had cleaned out the wound better, it would not have become infected. So he takes the case to the hospital, saying he "doesn't want to go to court because he still has to live in the community" (whatever that means), but states he'll go unless they cover the costs of staying in a hotel while he waited for his surgery. They're actually going to settle because it's cheaper than dealing with him. And I guess I'm glad, because if I'm named in a lawsuit, my med mal insurance premium goes up, regardless of the merits or outcome of the case. In fact, as one in the insurance industry put it, all they look at is the total money spent on the case, i.e. going to court and winning is often worse for my premium than settling early.

Is it any wonder why no one will take trauma call?

[ERCougar]

SCC probably knows this but for everyone else, diagnosing compartment syndrome requires sticking a large needle into the four muscle compartments of your calf to measure the pressures. As you can imagine, it's EXTREMELY painful, especially when your presenting complaint was likely to be calf pain. I'll propose something--every attorney that comes into the ER with calf pain, even if I'm totally convinced it's a pulled muscle or a sprained ankle, gets compartment pressures done because after all, it COULD be compartment syndrome, and "it's tough to diagnose if you don't even test for it". I wonder if that would lead to some tort reform.

Sheez...I AM grumpy.