🚀 go-pugleaf

buckland@ucs.ubc.ca (Tony Buckland) writes:
> 
> The current chapter in a continuing series of various health care
> crises in British Columbia concerns doctors' outrage and 
> countermeasures in the face of the Provincial Government's actions
> to cap the health care budget and, to that end, to cap billings to
> the (only) health insurance agency by individual doctors.
> 
> Coming up on three years into the emergence of the New World
> Order, and we have the irony of a BC Government seemingly intent
> on inventing anew Socialism With An Inhuman Face.

Here's a file with background information on the health care system in
Canada.  Those of you who saw CNN's series on it in early June already
know it.  It is not a National Health System like in Britain, just an
insurance plan.  The NDP (New Democratic Party, sorta Canada's Labour)
seem to be trying to steer it in the direction of socialized medicine
(Canadians do not consider their system to be "socialized", or it's
just that people here seem to have a broader definition of the word).
I am behind the doctors on this one; the best ones compete for their
business by good word of mouth and put in lots of hours for their
clients.

Also, please note that Canada is an independant country that will be
celebrating its 125th birthday this July 1st.  The only influence the
UK has had on our policies has been during the various wars up to WW2
(i.e., our pro-British leaders hopped on board quite uncritically).

[Seriously, I've had lots of mail asking about connection between UK
NHS and Canada's move to public insurance; until the 60's, almost all
western countries including USA had the same system, i.e., pay cash.]

Also, note that this issue affects only one of the 10 provinces; what
is happening in British Columbia has no impact on Quebec, no more than
the recent So. Cal. earthquake emergency affecting New Hampshire.



Canada has a public health insurance system ("PHI" in Americanese)
funding private doctors and public and private hospitals.  They are
paid on a per-procedure basis according to a fee shedule as per any
insurance plan in America.  Doctors' guilds in each province negotiate
the fee schedule, and their offices run the standard billing software
(97% are billed to the provincial plan).  Each province is in effect
an HMO, with every resident having access to choosing their own doctor
and hospital in that province (outsourcing to bigger, richer provinces
upon approval of the insurer/HMO).  France and Germany also have PHI;
all three are known as fiduciary in legalese (i.e., not an arm of the
government to pound on particular people, a fave American paranoia;
it's just a passive pool that pays bills).

The fee schedule is for the provincial HMO, but doctors can charge
higher rates in cash, too, and let the patient get the reimbursement.
No doctor is obligated to bill the provincial HMO, but if you're in
Canada it'd be stupid not too ... you'll find the odd loner who is
bogged down by ideology and goes the cash-only route.  Since our
doctors run private practices with billing software (97% of the
database entries are to the provincial health fund) they can take
cash.  In fact, a couple of my medical friends have said that they'll
only take cash from Americans (and let them sort things out with their
insurance) because they have been weasled by American private health
insurers when presenting bills for their clients.

Oh yeah, there is also private insurance in Canada for stuff that is
not basic medical (bandages to brain surgery).  This gives you perks
like one would get in a premium U.S. hospital like private room, a
cellular telephone, etc.  Private insurers are happy that it's all
they have to sell to individuals and for corporate bennies, and if the
Tories or Liberals ever dared to "go American" the political moneymen
at London Life, etc. will raise holy hell (friends in insurance tell
me that, anyways) before flashing their political donation money.

On the other hand, Great Britain runs a National Health Service (NHS)tm
which is closer to what Americans call "socialized medicine".  Doctors
are salaried out of the public purse and a bureaucrat oversees the use
of services (gee, doesn't this sound familiar? (-;).  NHS is not PHI.

[My own prediction is that the U.S. will go to a system where basic
coverage is covered by a public pool, but brokered by private firms
who will offer what we call "private supplementary" up north on top of
it all (basically, filling out what their current policies are).  The
same differentiations in the U.S. and Canada will remain due to the
presence of "private supplementary" and those who can pay for it.]

gld
--
~~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare				Elections 1992-93:
> gld@cunixD.cc.columbia.EDU		* Jean Chretien (Canada)
> gld@cunixc.BITNET			* H. Ross Perot (USA)