Medical watchdog looks at private MRI ban.

[Maxt]

http://www.calgaryherald.com/news/alberta/Medical+watchdog+wants+Alberta+private+MRIs/8850555/story.html

The province’s medical watchdog is proposing Alberta outlaw private diagnostic imaging because it allows patients with fat wallets to jump the queue.

The College of Physicians and Surgeons of Alberta will debate revised standards of practice next week that would make it unethical for doctors to provide preferential access to any insured service based on a patient’s ability to pay.

“We don’t think you should be able to buy an MRI or CT scan privately,” said college registrar Dr. Trevor Theman, “that it should all be a publicly funded service.”

Albertans currently wait as long as 37 weeks for an MRI in a public facility, but the imaging can normally be done within a couple of days at private clinic if a patient can afford the $700-plus cost.

The CPSA is already looking at tighter rules for doctors in the wake of revelations at a public inquiry this year that patients who paid membership fees of up to $10,000 a year at a private Calgary clinic got expedited access to cancer screening at a public facility.

New rules aimed at the fast-growing number of concierge clinics that often promise quick access and unrushed appointments would forbid physicians from charging fees for uninsured services as a condition of receiving medical care that is covered.

They would also restrict doctors from terminating their relationship with current patients who don’t want to pay the fees.

“The intention here is pretty clear, which is you shouldn’t be putting an economic barrier in front of people,” Theman said.

“They don’t need to buy a basket of uninsured services in order to be able to see you.”

But now a college committee — three doctors and one public member — wants to broaden the definition of insured services to include other sorts of diagnostic imaging.

“If you can pay for an MRI on your injured knee,” said Theman, “you might get earlier access to an orthopedic surgeon because you have the test result that shows you have a correctable condition.”

The country’s first private MRI clinic opened in Calgary two decades ago and there are now more than 11 such facilities in the province.

While the college’s entire governing council has yet to adopt the new rules, it has already informed the deputy health minister of the potential implications of the new rules.“We may be coming back to government and saying you should shut the door on this,” Theman said.

“We’re not an advocacy group for the profession. We’re an advocacy group for the public. That’s our raison d’etre.”Two private clinics in Calgary contacted by the Herald on Thursday did not respond to questions about the proposed rules and the potential impact on their business.

Health Minister Fred Horne was unavailable, but his press secretary said in an email that “the minister is open to hearing input from any group with regards to their views on the health-care system.”

Wendy Armstrong, spokesman for the Consumers’ Association of Alberta, lauded the college’s proposed changes.

“They’re long overdue,” said Armstrong, “and a positive outcome that clearly flows from a public inquiry that exposed the loopholes that are allowing those with money to buy preferential access to care.”

If the CPSA’s council OK’s the revised standards of practice at its meeting next Friday, physicians and the public will have two months to provide further input before the rules get final approval.


How is banning a private option in Alberta going to stop this, well healed people will just travel to other jurisdictions. If people can pay for faster treatment in a private clinic all the power to them, should lesson the burden on the public system. The issue of people buying their way into a public system is different than people paying their own way through the private system.

[codetrap]

Fuck that. I ponied up $1000 for an MRI so I could fast-track my initial hip diagnosis. Otherwise I would have had to wait a year to get into an MRI. What was the net result? I got into the hip replacement program a full year earlier, and some other poor bastard who couldn't afford to pay got his ass bumped up in line because I wasn't taking a spot anymore.

It also wasn't a couple of days. It was hours. I called them friday morning at 8:30, and they booked me in for 16:00 THAT DAY. Was it worth it? Not having to wait a year while being in constant pain, hell yeah.

And the guy who got my spot for the public queue, I'm betting he was pretty happy he bumped up because there was less load on the public system. These idiots shooting down this private clinic access can't see the forest for the trees. The net effect of them shutting these down is they're just going to increase wait times for everyone, because they're certainly not going to start throwing more money at it in order to shorten the wait times at all. They simply can't afford to.

These people are ridiculously stupid to even consider this.

[cet]

^ Could not agree more. What a rediculous proposition.

[rx7_turbo2]

I don't even know where to start. Alberta Health Care is such a bloated mess.

Here's food for thought, you think your wait for an MRI is long now? Workers Compensation Board currently utilizes private MRI services, take those people and add them to the cue lol.

I've had a number of scary medical issues this past year (2013 has sucked) I've had 2 MRI's and 2 CT scans. The thought of waiting 2+ years to find out if the mass in my kidney was cancer was enough to well.......give me cancer so I paid for all diagnostic imaging out of my own pocket. The care privately was exceptional, the exams were booked and occurred quickly and results were had in an equally timely manor. If I didn't have the option to pay out of pocket in this Province? I would have just gone to The States. AHS does not in any way shape or form have a patients best interest in mind. My dealings with them over the last 12 months makes me wish I had the ability to tell Alberta Health Care to go fuck themselves and just self insure. Right now I'm having to double pay. My taxes pay in part for the shitty public system, but if I want decent and timely care I have to pay out of pocket as well. Equally shitty health care for all, that's some great system!

[Maxt]

The message is , who cares if you are rich, or prioritized you spending, worked hard, or sold something to afford alternate treatment, you have to stand in line and suffer. How typically Canadian is that, less of course you are a politician..

[Cos]

.

[codetrap]

Originally posted by Cos

All I saw. Enough said. ;)
honestly, not that I disagree with how it is today and I dont disagree with people like CodeTrap paying. Actually I encouraged him to if i remember. That being said why dont we fix the fucking system? I was in Airdrie Urgent Care and they had a line up that would book them until 1pm. I stood in line at 7:55. You know how many doctors/nurses they had? 1 Dr and 3 nurses. Bull shit. Hire more people to take care of a population of 55,000.

Same with teachers, complain there are no teachers? Guess how many applied on the Gr. 2 job my wife got? 355. Yes 355 people wanted 1 job. We need more positions. Not 30 kids in a Gr. 2 class and month to month contracts.

Fuck I hate government. [/rant] You did. I think it was something along the lines of, "You're being a grouchy asshole, go get it done so you can get fixed faster." ;)

Edit: That's pretty impressive that your wife beat out all those other candidates. I had no idea it was so competitive. She should certainly be proud of that.

[CompletelyNumb]

Originally posted by Maxt
The message is , who cares if you are rich, or prioritized you spending, worked hard, or sold something to afford alternate treatment, you have to stand in line and suffer. How typically Canadian is that, less of course you are a politician..


:werd:


We should eliminate paying a rush fee for passports too. Or extra fees for custom plates. Or anything else that benefits those with extra spending money.

[bignerd]

If you have enough money and concern to pay for a private MRI, if banned here, you will just go to the nearest clinic in the US offering the same services. Might as well keep the jobs and money in Alberta IMO.

As well, no way Dr's are going to go for this, they own and operate most of the clinics out there that offer the private services...

[Modelexis]

It's like suggesting people be banned from flying in airplanes rather than using their communist government subsidized lada to travel within the country.

The problem is communism, not tweaks of the system.


”Two private clinics in Calgary contacted by the Herald on Thursday did not respond to questions about the proposed rules and the potential impact on their business
I wonder why a business owner would not respond to a communist threatening to have him put in jail for continuing to provide healthcare to Canadians.

On the devils advocate side of things, you gotta give the watchdog credit for at least being consistent and honest with the fact that they are communists and they are consistent with their position.

Either violent communism is good or it is criminal. If it's a good thing we should ban private MRI. If it's a bad thing we should abolish any form of public healthcare funded by taxes and monopolized under a threat of violent force.

If you're a Canadian in favor of publicly funded healthcare I hope they do ban private MRI and any other private aspects of healthcare. You can't have your cake and eat it too.

I like how communists consider you rich if you can work hard enough to afford a 700$ MRI.

[Maxt]

Healthcare is so politically connected and run with an ideology in this country that fixing it in its current structure is damn near impossible. It would mean gutting the system and protecting it from political interference, a lot of outsourcing and the removal of organized labour from some of the process, stuff that gets the Raging Granny's and Cupe types all riled up on how the world will stop turning even if the outcome is an improved system.
Allow it to be universal, publicly insured, services privately provided, with a physician based review board.

[Modelexis]

Originally posted by Maxt
Allow it to be universal, publicly insured, services privately provided, with a physician based review board.

I'm picturing food stamp style healthcare, correct?

[CanmoreOrLess]

Here's an idea, tack on an extra $10 for every speeding ticket issued in any Alberta city, bang in a few years we are known as the MRI /CT scan province in Canada. Next issue? I solve 'em in less than an hour.

[Xtrema]

It's only machines and a few techs. We are not talking about surgeons and doctors. AHS can't staff people anyway. Let people who can afford it skip the queues and make room for someone else.

The next service we should privatize is prenatal and labor. Having baby isn't a medical condition. It's a choice. Let's free up resources to other urgent cares.

[codetrap]

Originally posted by Xtrema
It's only machines and a few techs. We are not talking about surgeons and doctors. AHS can't staff people anyway. Let people who can afford it skip the queues and make room for someone else.

The next service we should privatize is prenatal and labor. Having baby isn't a medical condition. It's a choice. Let's free up resources to other urgent cares. WTF? Being pregnant isn't a medical condition? LOL. Really? I just about spit my coffee out when I read that. hehe.

You can have a private birth if you want btw. There are private birthing clinics, and private midwives. You can have them. When my next taxpayer is ready to pop out, I'm definitely going to take advantage of everything that is currently offered for medical benefits.

[xrayvsn]

Originally posted by Xtrema
It's only machines and a few techs. We are not talking about surgeons and doctors. AHS can't staff people anyway. Let people who can afford it skip the queues and make room for someone else.

The images don't interpret themselves, and the techs don't read the study, or protocol them. So, yes, you still are talking about doctors (radiologists) who interpret all of the imaging.

[Xtrema]

Originally posted by codetrap
WTF? Being pregnant isn't a medical condition? LOL. Really? I just about spit my coffee out when I read that. hehe.

You can have a private birth if you want btw. There are private birthing clinics, and private midwives. You can have them. When my next taxpayer is ready to pop out, I'm definitely going to take advantage of everything that is currently offered for medical benefits.

Most pregnancies are voluntary. You are forced to have a baby as much as you are forced to buy a $1M mansion.

So let's have some choices out there and free up resources for other cases.


Originally posted by xrayvsn
The images don't interpret themselves, and the techs don't read the study, or protocol them. So, yes, you still are talking about doctors (radiologists) who interpret all of the imaging.

Well at least we get rid of one queue. The other queue is harder to get rid of.

[-relk-]

Originally posted by Xtrema

Most pregnancies are voluntary. You are forced to have a baby as much as you are forced to buy a $1M mansion.

You can't accidently get approval on a mortgage for a $1M mansion when your making $40 grand a year ;)

[rx7_turbo2]

Originally posted by -relk-

You can't accidently get approval on a mortgage for a $1M mansion when your making $40 grand a year ;)

You're right, there are checks in place to make sure it doesn't happen. I wish there was something that could prevent pregnancy as effectively, like a condom, or birth control, or shit abstinence.

[M.alex]

Stupid stupid stupid. What happened to the Alberta that was filled with rednecks who loved nothing more than money, oil, money, guns and strippers. Now it's filled with a bunch of whiney ass bitches for the most part :thumbsdow

[KRyn]

If you have the money you should be able to pay for things like a MRI or CT scan. I don't see how this could create substantial wait times for other people. If anything it is creating more tax revenue to pump into the public system.


Originally posted by M.alex
Stupid stupid stupid. What happened to the Alberta that was filled with rednecks who loved nothing more than money, oil, money, guns and strippers. Now it's filled with a bunch of whiney ass bitches for the most part :thumbsdow


Yah, whiney ass bitches that drive cars with four or six cylinders. What ever happened to the good old days in Alberta when everyone drove cars with V8s?

[dexlargo]

The problem with allowing those with money to pay for their own services with higher efficiency is that it essentially allows conservative governments to underfund healthcare.

If the effects of underfunding healthcare don't affect those who have money, the people who have money will not object to underfunding these procedures.

The people with money are the ones who are influential on government and really effect whether or not politicians are re-elected.

So the poor suffer, the middle class and up are largely unaffected, and the government gets to save the money it would have to spend on MRIs for those who choose to pay for it themselves.

Why even have public healthcare if we aren't going to actually demand that the public health system provide the services that we need?

Another example may show why the current system is wrong:

This situation is analogous to the situation in many US states with their public education system. The state underfunds the public education system, only paying teachers 20-30k per year. Only the very young and people who can't make better money elsewhere take those teaching positions, so there's a lack of skilled teachers and many are completely unqualified. Because of that, the public education system sucks in those states (I'm thinking in particular of the Chicago public school system that no one there uses unless they have no choice).

Because the public education system sucks, those who can afford to do so, put their kids into private schools that provide better education than the public system.

Because the rich and middle-class can get acceptable education within their means, they don't complain, and the system continues.

Who suffers? The poor. This greatly restricts the ability of children from poor families to have a chance of changing their fates.

What's the solution? Create a universal system that gives acceptable results for all people.

If a private clinic can provide an MRI for 700-1000 dollars, why doesn't the Province pay that? I can't imagine that the cost for the Province owned and operated MRIs is really that much lower. In fact I wouldn't be surprised if the Province's overall cost per MRI is that amount or even more.

I don't think there's harm in having a privately run clinic - but their should only be one payor - Alberta Health Services.

Does believing the above make me a communist? If you want to look at it that way, fine.

[rx7_turbo2]

Originally posted by dexlargo
but their should only be one payor - Alberta Health Services.


That scares the living shit out of me!

The LAST entity I want in charge of my health is Alberta Health Services. The current system has shown time and time again it cares very little about individuals health. It's a bloated mess that provides a substandard level of service to everyone. Lowest common denominator health care, I'd rather have another option thanks.

[Thomas Gabriel]

Originally posted by M.alex
Stupid stupid stupid. What happened to the Alberta that was filled with rednecks who loved nothing more than money, oil, money, guns and strippers. Now it's filled with a bunch of whiney ass bitches for the most part :thumbsdow

We've been corrupted by communist transsexual Easterners. They should be forced to wear patches on their arms.

[codetrap]

Originally posted by dexlargo
What's the solution? Create a universal system that gives acceptable results for all people. While we're at it, why don't we start a unicorn farm. Look what happened to Duckett. He started to actually shake things up and ended up getting fired over a cookie comment. The entire political BS surrounding him was pure theater in order to get rid of him because he was severely cutting funding and the "movers and shakers" behind the scenes didn't like that at all.



Originally posted by rx7_turbo2
That scares the living shit out of me!

The LAST entity I want in charge of my health is Alberta Health Services. The current system has shown time and time again it cares very little about individuals health. It's a bloated mess that provides a substandard level of service to everyone. Lowest common denominator health care, I'd rather have another option thanks. I agree with this to a point. On the bureaucratic level, AHS couldn't give a flying f**k about us. However, my experience with the frontline staff has always been excellent. There are a lot of high quality people in AHS, unfortunately their leadership seem to be consistently a bunch of total assholes.

[suntan]

Originally posted by M.alex
Stupid stupid stupid. What happened to the Alberta that was filled with rednecks who loved nothing more than money, oil, money, guns and strippers. Now it's filled with a bunch of whiney ass bitches for the most part :thumbsdow Fuck I miss duo week at the maid. And what's with the no touching between me and the strippers? If I want to get herpes from them it should be my choice.

[rx7_turbo2]

Originally posted by codetrap
I agree with this to a point. On the bureaucratic level, AHS couldn't give a flying f**k about us. However, my experience with the frontline staff has always been excellent. There are a lot of high quality people in AHS, unfortunately their leadership seem to be consistently a bunch of total assholes.

Stop the presses! You and I agree?

I was careful with my wording when I said "The System doesn't give a fuck" The frontline people I've dealt with this past year have been nothing short of exceptional. Some of my experiences with them I don't remember, and was incapacitated and unconscious for, but at no point did I ever think the staff member I was dealing with didn't care about me as a person.

It's what makes the situation in this Province so sad. The system has excellent frontline staff that is capable of providing top notch service, but they're handcuffed, wearing concrete shoes, and treading water in a sea of bureaucratic nonsense with no leader. Handing more of the control over to that failure of a system is a massive step backwards.

[suntan]

Originally posted by Maxt
Allow it to be universal, publicly insured, services privately provided, with a physician based review board. Our health care is universal.

It is publicly insured.

Services are privately provided.

The catches are:

When you say "publicly insured", that doesn't mean that all health care is publicly insured. It doesn't exclude private care. Fact is, you can't have everything publicly insured. Does it make sense for a doctor to charge AHS for a doctor's note saying that someone is too sick to come into work? How about eye exams and corrective lenses? They're not covered once you're over 18. Should they be included for everyone?

Not all services are privately provided. Hospitals are usually publicly run, and the doctors, nurses, etc are state employees. Your family doctor usually runs a professional corporation. He simply bills AHS for his services provided and tries to be viable within that revenue. Doctors at hospitals don't necessarily have to be employees either - my wife's extremely hot female doctor delivers babies at the Rockyview and is also a family doctor at her own office.

[Xtrema]

Originally posted by dexlargo
If a private clinic can provide an MRI for 700-1000 dollars, why doesn't the Province pay that? I can't imagine that the cost for the Province owned and operated MRIs is really that much lower. In fact I wouldn't be surprised if the Province's overall cost per MRI is that amount or even more.

Simple. When you rule out competition, the cost will be much higher.

Sure an MRI is only 700-1000 when it's elective and you have to fight to get your share of thousands of customers. The minute it become single payer from government, competition is gone and you don't have to discount to fight for your share of the pie.


Originally posted by rx7_turbo2
It's what makes the situation in this Province so sad. The system has excellent frontline staff that is capable of providing top notch service, but they're handcuffed, wearing concrete shoes, and treading water in a sea of bureaucratic nonsense with no leader. Handing more of the control over to that failure of a system is a massive step backwards.

Agreed.

[BigMass]

What about dental? Why don't they fund that? Dental is a HUGE part of human health and should take a priority over a lot of other services. I want to hear the rationale behind that

[Maxt]

Originally posted by BigMass
What about dental? Why don't they fund that? Dental is a HUGE part of human health and should take a priority over a lot of other services. I want to hear the rationale behind that
Good question... Maybe because a lot of it is cosmetic? Where would you draw the line on service, functionality or a spending limit?

This is interesting:
http://www.fraserinstitute.org/uploadedFiles/fraser-ca/Content/research-news/research/publications/health-care-lessons-from-japan.pdf

[Seth1968]

Originally posted by BigMass
What about dental? Why don't they fund that? Dental is a HUGE part of human health and should take a priority over a lot of other services. I want to hear the rationale behind that

I've wondered about that as well, as oral health is critical to well being.

I recall reading something that by law, AH has to cover medically necessary dental work. That is of course, dental issues that are causing physical illness.

Can anyone confirm that?

[Seth1968]

Originally posted by Seth1968


I've wondered about that as well, as oral health is critical to well being.

I recall reading something that by law, AH has to cover medically necessary dental work. That is of course, dental issues that are causing physical illness.

Can anyone confirm that?

I just called 3 dental offices, and each said AH doesn't cover ANY dental work. That didn't sound right to me. I just found this:


Dental Some specific dental, oral and maxillofacial surgical services are fully covered. Routine dental care is not covered, such as cleaning, fillings and the extraction of wisdom teeth. The patient, or their secondary insurer (if applicable), is responsible for paying additional costs not covered under the Alberta Health Care Insurance Plan. Ask your dentist for details. To find out what is covered, read the Schedule of Medical Benefits and the Schedule of Oral and Maxillofacial Surgery Benefits Read about services not covered by the Alberta Health Care Insurance Plan

http://www.health.alberta.ca/AHCIP/what-is-covered.html

"Ask your dentist for details". Ya, that was a great help.

[CUG]

Ontario, you're leaking again.

[Sugarphreak]

...

[Maxt]

In AHS' s case, healthcare makes rich people.

[frizzlefry]

Isn't the health care big wigs bonuses based on how much they save and or cut costs? Thats a problem right there.

Co-worker of mine figures that there should not be private medical services because unless wealthy influential people have to suffer in the system then the system wont get fixed.

I'm not sure I agree with that but its an interesting thought.

[Sugarphreak]

...

[msommers]

I'd agree with that. And the top dogs at AHS are running a broken system and obviously can't handle the constant pressure.

[Maxt]

Originally posted by Sugarphreak
^^ I actually agree with that

People in the top positions should be making big coin and getting bonuses. Why?

There are not that many people out there capable of running huge organizations effectively, and those that can are run off their feet. It is a difficult job, it is very stressful and high demand, people are constantly trying to undermine you, and generally it is not really a desirable position to be in. If you don't pay accordingly, the private sector will and qualified people won't be available for the job.

I doubt that there is a single person on Beyond that could go and do that position, we might all think the pay is pretty awesome, but when push comes to shove they earn it.

Typical public ignorance when it comes to this stuff, as soon as somebody starts making 6 figures all the watch dogs get up in arms. Who the fuck would put themselves through that for less?


Minus the cookie monster Mr Duckett, he was an idiot. :rofl:
The issue probably isn't the money, its the performance for the money.. If there were no wait lines, people dying on lists and beds being stretchers in hallways, there would have been a lot less inward attention payed to the hierarchy at AHS.

[sexualbanana]

Originally posted by M.alex
Stupid stupid stupid. What happened to the Alberta that was filled with rednecks who loved nothing more than money, oil, money, guns and strippers. Now it's filled with a bunch of whiney ass bitches for the most part :thumbsdow

They're all in the private sector making 5x more money

[Maybelater]

Originally posted by Sugarphreak
I don't see the problem; if somebody wants to pay a premium to skip out of the cue, all it does is make the line shorter for those who are not able to. It is a win win situation.


It makes the line longer for every person who was ahead of them in the queue :rolleyes:

[rx7_turbo2]

Originally posted by Maybelater


It makes the line longer for every person who was ahead of them in the queue :rolleyes:

Huh? :dunno:

[sexualbanana]

Originally posted by rx7_turbo2


Huh? :dunno:

I think he's basing his argument on sharing public equipment vs. private clinics with their own machines.

[rx7_turbo2]

Originally posted by sexualbanana


I think he's basing his argument on sharing public equipment vs. private clinics with their own machines.

I think you're right.

Maybe he's not sure about how it actually works?

[Maybelater]

Originally posted by rx7_turbo2


Huh? :dunno:

Sorry, I read the sentence wrong. :nut:

I do think a public-private system is something worth looking into, most of the worlds best medical systems are based on this model.

[rx7_turbo2]

Originally posted by Maybelater


Sorry, I read the sentence wrong. :nut:

I do think a public-private system is something worth looking into, most of the worlds best medical systems are based on this model.
:thumbsup:

[bignerd]

My understanding is that the problem is not that people can get private exams but is that they can get the treatments and surgery faster than someone that has to go through the public system?

So if they do ban private imaging here what will they do when someone goes to the states to have a scan done? Refuse to use the results? Make you wait for surgery as if you had waited on the public waitlist?

Like I said if you have money for a private CT/MRI then you have money to go to the nearest US clinic for the same thing.

[Toma]

Privatized and For Profit medicine is COMPLETELY unacceptable, and unsustainable, immoral, and paves a very scary path.

Not sure imaging and private labs are so bad, but you have to draw the line somewhere and prevent the cancer from spreading throughout our system.

[Modelexis]

Originally posted by Toma
Privatized and For Profit medicine is COMPLETELY unacceptable, and unsustainable, immoral, and paves a very scary path.

I'm trying to figure out what part of our semi-socialized healthcare is not for profit.
The doctors make a profit, the healthcare insurance companies that provide coverage for drugs make a profit, the drug companies make a profit, the pharmacists make a profit. Drugs in Canada are private and for profit for the most part as far as I know.


According to the 2009 Alberta Wage and Salary Survey, general practitioners and family physicians earned:

a base minimal average annual salary of $94,101;
average minimum rate of compensation of $48.01 per hour;

average maximum rate of $137.36 per hour.

The above wages and salaries do not include overtime hours, tips, benefits, profit shares, bonuses unrelated to production and other forms of compensation.

According to the Alberta Health and Wellness Alberta Health Care Insurance Plan Statistical Supplement (page 35), general practitioners and family physicians earned a minimal average annual salary of $231,902.

http://www.albertacanada.com/immigration/working/hc-doctors-gp.aspx

So just to understand your statement, it's dangerous when who makes a profit exactly?

[Toma]

Originally posted by Modelexis


I'm trying to figure out what part of our semi-socialized healthcare is not for profit.
The doctors make a profit, the healthcare insurance companies that provide coverage for drugs make a profit, the drug companies make a profit, the pharmacists make a profit. Drugs in Canada are private and for profit for the most part as far as I know.



http://www.albertacanada.com/immigration/working/hc-doctors-gp.aspx

So just to understand your statement, it's dangerous when who makes a profit exactly?

Why are you confused about the difference between Profit and Wage?

And Socialized medicine is how it HAS to be for many reasons.

Insurance for Drugs.... yeah I can kinda live with that, though to be fair, that SHOULD be socialized as well. Realistically, the typical drugs the majority need are dirt cheap anyway.

[Modelexis]

Originally posted by Toma
Why are you confused about the difference between Profit and Wage?

Not too sure, it seems to be a struggle for me for some reason.
My understanding was that they are related and are not two separate and different concepts.

Without a profit you can't have a wage as far as I understand.
Profit creates a possibility for a wage, the higher the profit the higher the wages. ie: oil and gas have high profits so the wages are higher generally.

If I have a private medical practice and I pay myself a wage based on what is left over after I've paid my overhead, wouldn't that wage be the fruits of my profit?
My boss would always say in regards to raises that if the company is doing well they can translate that into higher wages for us workers.
So in that situation I would imagine the profits directly translate into wages.
So wages would be an indicator of profits.

Or maybe I'm confused?

Is it that profits vary and wages are a steady chunk of those profits?


the ratio of such pecuniary gain to the amount of capital invested

based on that definition of profit, you could say the doctor invested capital into school and is now making a profit from that invested capital.

Regardless of the terms used, the doctors in a socialist healthcare system are making money through their role in providing healthcare.
Making money is still their motivation for becoming a doctor as well, no matter if it's socialist healthcare or private, the motivation is still money.

If it cost the same amount to get a to the point where you can operate as a family doctor but the position paid $9.50 per hour how many doctors would go through all the schooling and pay all the money to do that?

I'm sure a lot of private business owners would give up their profits to take in a doctor's salary.

It has generally the same flow for private business as it is for public services. Money is paid for product/service and comes out the other side in the form of wages and profits. Not sure the difference between charging fees directly and making a 250k profit and having a solid 250k wage per year.

I can see positives and negatives of both direct profit and solid wages.

According to the stats in the earlier article, a base salary of 90 grand and they are making a profit above and beyond that to the point where the average salary ends up around 250k

[Maxt]

Originally posted by bignerd
My understanding is that the problem is not that people can get private exams but is that they can get the treatments and surgery faster than someone that has to go through the public system?

So if they do ban private imaging here what will they do when someone goes to the states to have a scan done? Refuse to use the results? Make you wait for surgery as if you had waited on the public waitlist?

Like I said if you have money for a private CT/MRI then you have money to go to the nearest US clinic for the same thing.
You are correct, thats how they say some are queue jump jumping... Next step making all medical treatment outside of Alberta illegal except for travel emergencies?
With all the money AHS gets there really is no excuse for the rationing of healthcare in this province.

[codetrap]

Originally posted by Maxt
You are correct, thats how they say some are queue jump jumping... Next step making all medical treatment outside of Alberta illegal except for travel emergencies?
With all the money AHS gets there really is no excuse for the rationing of healthcare in this province. So, you're saying that I effectively jumped the queue for my hip replacement surgery because I was able to pay for an MRI. I guess an argument could be made for that. I'm not entirely sure that's unfair though, because the same argument can be made for all the people that are in the public diagnostic system that are getting MRI's faster due to less people in it.

As an aside, I WAS actually able to claim that MRI on my Health Spending Account through Sunlife. I've also talked to other people who were able to do the same through Blue Cross. So, the private insurers recognize the value of getting their people fixed faster, with a focus on prevention of expensive complications.

[Maxt]

Originally posted by codetrap
So, you're saying that I effectively jumped the queue for my hip replacement surgery because I was able to pay for an MRI. I guess an argument could be made for that. I'm not entirely sure that's unfair though, because the same argument can be made for all the people that are in the public diagnostic system that are getting MRI's faster due to less people in it.

As an aside, I WAS actually able to claim that MRI on my Health Spending Account through Sunlife. I've also talked to other people who were able to do the same through Blue Cross. So, the private insurers recognize the value of getting their people fixed faster, with a focus on prevention of expensive complications.
Thats what the College is saying, I can see the argument they are making. But If anything this should be an incentive for them to get things sped up for everyone, and address the wait times for diagnostics. But they take the typical heavy handed Canadian style approach of just making it worse for everyone. Sometimes I really think to be Canadian means to "impede".
What I would like to see is the ratio of Private to Public MRI's and the performance numbers for the throughput.
I can tell you from first hand experience with foreign healthcare, is that the Albertan system of patient handling seems to be focused on paper work rather than patient care.

[Sugarphreak]

...

[Modelexis]

Originally posted by Sugarphreak
The USA is a great example of how the private sector has run away with it. It is scary there, I got a bad sunburn few years back and a 5 minute consultation cost me 850$!

If there is an underlying public system that people can go to for free, then when private sector prices get too high people just stop going and it forces them to drop their prices.

_Zdqp22G_K4

http://www.surgerycenterok.com/pricing/

[suntan]

Originally posted by Modelexis
Confused rant snipped...

You don't know WTF "profit" means. I guess you've never read financial statements.

Profit is a specific term. It's:

REVENUE - EXPENSES - TAXES - DEPRECIATION = PROFIT!!!

REVENUE is the money you take in.

EXPENSES are things you spend money on. WAGES ARE A KIND OF EXPENSE.

You don't pay people from "PROFIT". You pay them from "REVENUE".

When someone says that an organization is NON-PROFIT, that means that try to match their expenses to their revenue.

Does that make sense? Maybe take a beginner's accounting course somewhere because holy fuck stop talking about this sort of stuff until you can comprehend it.

[dirtsniffer]

:clap:

[Nitro5]

.

[Modelexis]

Originally posted by suntan


You don't know WTF "profit" means. I guess you've never read financial statements.

Profit is a specific term. It's:

REVENUE - EXPENSES - TAXES - DEPRECIATION = PROFIT!!!

REVENUE is the money you take in.

EXPENSES are things you spend money on. WAGES ARE A KIND OF EXPENSE.

You don't pay people from "PROFIT". You pay them from "REVENUE".

When someone says that an organization is NON-PROFIT, that means that try to match their expenses to their revenue.

Does that make sense? Maybe take a beginner's accounting course somewhere because holy fuck stop talking about this sort of stuff until you can comprehend it.

Holy man, take it easy. This is the internet just so you know...

What if I'm a doctor and I start a doctor office and just pay myself a high wage that consumes almost all of my annual revenue and anything left over I give myself as a yearly bonus.

Does that mean I made zero profit that year?

How is it different whether I pay myself in a wage or just take the money directly?

Talking about things you struggle with is how I learn the quickest, being corrected when I'm wrong etc.
I don't need a lecture on how terrible it is to be incorrect on the internet.

I can take criticism without the need to bundle it with all the condescension and rage.

[suntan]

Dude, I'm not the one that wrote a gigantic, extremely confused post where every point you tried to make was wrong.


What if I'm a doctor and I start a doctor office and just pay myself a high wage that consumes almost all of my annual revenue and anything left over I give myself as a yearly bonus.

Does that mean I made zero profit that year?It means the company made zero profit.

It does mean that the doctor will have to pay a lot of income tax.

This is preferred greatly by both the provincial and federal governments. Why? Because income tax rates are much, much, much higher than corporate tax rates (The tax rate for small businesses in Alberta is 13.5%). Municipalities don't give a shit because they tax based on property values, not income.

There are a few workarounds that save a few thousand dollars, but for the most part Canada's taxation system is designed so that withdrawing money as dividends or wages get taxed at around the same rate.

For someone like a doctor, it only makes sense to keep money in the company if there's a long term plan for capital spending, since retained earnings are after-tax money.

[Modelexis]

So let's say you have a not-for profit doctor (doctor #1) running a not-for profit doctors office and a for profit doctor (doctor #2) running a for profit office.

Each company is one owner who is also the lone employee.

At the end of the year the revenues for doctor #1 amount to $250k
the revenues for doctor #2 amount to the same $250k

Socialist doctor #1 (his company) ends up with no 'profit' but a wage of $250k which he pays income tax on etc.

Capitalist doctor #2 invests $100k into the company and pays himself $150k which he is taxed on.

Is that the main difference between a for profit and socialist not-for profit company?

One is allowed to invest capital in the company and the other is not?

[R-Audi]

Spoke to a Radiologist friend who happens to own a clinic..

His views are that it normally takes an average of 14 months for someone to get in for an MRI through the normal avenues. If you have a serious cancer, that means you could be dead.
On the other hand, if someone can afford to head down south to the Mayo clinic where ever, they get their MRI within a month and typically head back to Canada for treatment.
If this continues, more top radiologists will continue to take jobs down south because they already get paid more to do so. (Or BC/Sask/Ont.. that allow semi private)

So at the end of the day, is it better for both people to possibly die because of the wait time, or allow other someone who can afford it to skip the bottleneck in the system that also happens to keep top radiologists in the system.

Cliff notes:
1. No private/semi private
-People die from wait times
-Ab Health loses top radiologists.

2. Allow semi private
-Those with $ live
-Better Drs. in system.

[Modelexis]

Originally posted by R-Audi
His views are that it normally takes an average of 14 months for someone to get in for an MRI through the normal avenues.

Not to nit pick but his view on this seems to be false based on the available studies:

14 weeks would be more accurate but still a high estimate

Alberta average is about 8 weeks from 2012 data
Canada average is around the same:

http://www.fraserinstitute.org/uploadedFiles/fraser-ca/Content/research-news/research/publications/waiting-your-turn-2012.pdf

[ipeefreely]

Originally posted by R-Audi
If you have a serious cancer, that means you could be dead.

If you have cancer you go to the front of the line... they don't let you wait at the back of the line till you die... :facepalm:

[codetrap]

Originally posted by Modelexis


Not to nit pick but his view on this seems to be false based on the available studies:

14 weeks would be more accurate but still a high estimate

Alberta average is about 8 weeks from 2012 data
Canada average is around the same:

http://www.fraserinstitute.org/uploadedFiles/fraser-ca/Content/research-news/research/publications/waiting-your-turn-2012.pdf I'll pick that nit. My scheduled appointment date was 11 months. These studies are bullshit. Pure and simple.

[M.alex]

Originally posted by Modelexis


Not to nit pick but his view on this seems to be false based on the available studies:

14 weeks would be more accurate but still a high estimate

Alberta average is about 8 weeks from 2012 data
Canada average is around the same:

http://www.fraserinstitute.org/uploadedFiles/fraser-ca/Content/research-news/research/publications/waiting-your-turn-2012.pdf

Those 'studies' are bullshit. I had to wait on average 8-10mths for every MRI I had, one of them for when they wondered if I had stomach cancer (turns out to be heart related, but that's another story).

The problem is you have a bunch of healthy people here commenting on a system they've never experienced first hand (I got to see our wonderful medical system after it took 8yrs to diagnose my heart problem, and I got to run the gaunlet all the way from gastro to neurology before I found the answer ..... our system FVCKING SUCKS in terms of timeliness to see specialists or testing beyond the basic stuff .... anybody who disagrees with that hasn't seen it first hand).


Originally posted by ipeefreely


If you have cancer you go to the front of the line... they don't let you wait at the back of the line till you die... :facepalm:

No, it's not that bad (no soup for jo, back of the line), but you still end up waiting a significant amount of time.

[R-Audi]

Originally posted by ipeefreely


If you have cancer you go to the front of the line... they don't let you wait at the back of the line till you die... :facepalm:


Im just going by his story. I dont know the specifics of each case and line jumping. I am sure there is availability based on seriousness, but he was going on a real world example of one of his friends.
Could have been a busy time, he could be exaggerating.. I dont know.

[Modelexis]

I take that back then, I didn't know these studies were so corrupt.

[rx7_turbo2]

Originally posted by ipeefreely


If you have cancer you go to the front of the line... they don't let you wait at the back of the line till you die... :facepalm: :banghead:

How exactly do you get the diagnosis of cancer in the first place? Oh that's right diagnostic imaging. Which means that yes there are in fact MANY, MANY people with cancer waiting in line to get that diagnosis, they don't know they have cancer of course. Sadly.

[tirebob]

Originally posted by R-Audi



Im just going by his story. I dont know the specifics of each case and line jumping. I am sure there is availability based on seriousness, but he was going on a real world example of one of his friends.
Could have been a busy time, he could be exaggerating.. I dont know. I went in for some crazy headaches and after a few tests was sent in for a CAT scan the next day. After the CAT Scan there was something that wasn't conclusive but they wanted checked and I was in for an MRI within 7 days...

The system does not just let people die because of long lines... It could definitely improve for people with non-life threatening but debilitating issues, but they don't just let potential life threatening issues simply line up for months on end...

[codetrap]

Originally posted by tirebob
I went in for some crazy headaches and after a few tests was sent in for a CAT scan the next day. After the CAT Scan there was something that wasn't conclusive but they wanted checked and I was in for an MRI within 7 days...

The system does not just let people die because of long lines... It could definitely improve for people with non-life threatening but debilitating issues, but they don't just let potential life threatening issues simply line up for months on end... Having met you in person, I could see why you'd want to get your head examined. ;) :nut:

[Cos]

.

[bignerd]

They don't need more MRI techs, pretty sure they are fully staffed. You pretty much only get a job here if someone moves or dies.

I thought the biggest factor was that depending on the types of magnets, MRI machines can cost upwards of a million dollars.

[msommers]

Don't we (Albertans) pay some of the highest per capita medical costs but have some of the country's longeset wait times?

[7thgenvic]

Very interesting thread from start to finish.

I have a few friends who are Radiologists. One of which owned and sold her share in the past year.

Do I agree with paying for a private clinic to view the MRI. HELLS YES.

If I can afford it, I'll pay it. Especially if it came down to a life and death situation. I also have US health care from our companies, so yes maybe I could be clustered into those who might be privileged enough to avoid these waits.

But when I look at our current system, and look at the opportunity to pay for these treatments I will take advantage of the benefits they pose. It's the way the world works and it won't change.

If my wife had cancer and wasn't getting diagnosed quick enough in our current system, I would GLADLY pay the cash. EVEN if it meant putting myself into a difficult financial situation. I think anyone here would pony up the doe if it meant life or death.

[xrayvsn]

Originally posted by bignerd
They don't need more MRI techs, pretty sure they are fully staffed. You pretty much only get a job here if someone moves or dies.

I thought the biggest factor was that depending on the types of magnets, MRI machines can cost upwards of a million dollars.

Most are well over a million to purchase. That does not include the constant maintenance they require to keep operating. Maintenance will be another million or more a year.

One of the many issues here is that there is not enough MR time for the demand. Unfortunately, many referrals for MRI are inappropriate, even though we try to weed them out by providing appropriatness criteria, people are still being sent in for these tests, because that is what patients are demanding. For example, I see those who have clear evidence of advanced osteoarthritis in their hips, knees or shoulders getting MRI for pain, when the x-rays give the answer, but they want a "better" answer. Not surprisingly, the MRI depicts other internal abnormalities that are usually comorbid with the arthritis, but does not impact the patient's management.

Unfortunately, patients often can't even get in to see a specialist until after they have their imaging done, further forcing everyone's hand into getting the MRI. We are also allowing non M.D's to refer for MRI, which drives utilization even higher.

Waitlists are the issue here. The cause for that is many, but increased utilization, (in)appropriate use of resources, and limited capacity to serve everyone because of a limited budget. We can't afford the type of healthcare system everyone wants, pure and simple. It isn't sustainable as it is now, and waitlists will only get worse as our population ages.

[rx7_turbo2]

Originally posted by xrayvsn
We can't afford the type of healthcare system everyone wants

Completely agree.

However there will always be people who CAN afford the care they want for THEMSELVES. I don't see the issue with that provided they are not opting out of financially supporting the public system as well.

[Sugarphreak]

...

[blitz]

Originally posted by tirebob
The system does not just let people die because of long lines... It could definitely improve for people with non-life threatening but debilitating issues, but they don't just let potential life threatening issues simply line up for months on end...

Unless your not flagged as a life threatening issue, wait 7 months for an MRI, and then it turns out it more serious. It is a diagnostic test afterall.

[xrayvsn]

Originally posted by rx7_turbo2


Completely agree.

However there will always be people who CAN afford the care they want for THEMSELVES. I don't see the issue with that provided they are not opting out of financially supporting the public system as well.

I wasn't arguing against private MRI. In fact, my group is one that would be impacted by the CPSA ruling against private MRI clinics, so this topic is of particular interest to me.

[rx7_turbo2]

Originally posted by xrayvsn


I wasn't arguing against private MRI. In fact, my group is one that would be impacted by the CPSA ruling against private MRI clinics, so this topic is of particular interest to me.

I wasn't suggesting you were arguing against private MRI, if it read that way I apologize. Your insight given your position is of great interest, and extremely valuable to this thread.

[frizzlefry]

Originally posted by blitz


Unless your not flagged as a life threatening issue, wait 7 months for an MRI, and then it turns out it more serious. It is a diagnostic test afterall.

I'm honestly not sure how much has changed but when I was in Jr High (1993) there were the same concerns with wait times etc. I had a seizure in Jr. High preceded and followed by a massive migraine. Within 48hrs I had an MRI, CAT scan and EEG all closely supervised and personally handled by a neurologist. Just in case it was urgent.

Luckily I was fine, they found the root issue (insomnia) and all is well.

A buddy of mine wiped out just last winter and hit his head. He was ok, walking talking insisted he was fine. The foothills got him in for a CT right away, just in case.

So in my experience clearly urgent cases, if classified urgent, have no issues getting immediate access to the tech required. If people are not being diagnosed properly and not being classified as urgent, thus not getting instant access to the tech, then I fail to see how this is a queue issue or private hurting public. The initial diagnosis is the problem. There are no wait lines hurting people with the right diagnosis. If properly escelated you should get in right away. So, if they missed a cancer wait lines were not the issue. Its that the attending Doc overlooked something or did not exercise proper caution.

Is that the problem with private MRIs? I don't think so. It's the bonus structure set up to reward public sector big wigs for cost cutting that quarter. Delay it now, not urgent, keep our numbers low for now, deal with it later. And that pressures doctors to help the budget bonus goal thus negativly affecting their diagnosis.

So I guess the public system is kinda for profit, if you are a public health care exec.

*edit* to directly address your statement blitz, what is the threshold then for any expensive diagnostic test? Everyone can't get in right away for anything. Costs would be through the roof. So you are right, unless that initial diagnosis requests the MRI you will wait. If it does request it, you are in the next day.

Issue is with the diagnosis, not wait lines.

Maybe if bonuses were paid to in relation to number of people cured rather than money saved doctors would feel less pressure to keep the MRI in their pocket rather than whip it out ASAP.

Banning private clinics only harms people who are willing to pay for them and helps no one else. Stinks of "the perception of equality = a properly run public system". No, its a PR stunt to cover up a poorly run public system thats neglecting a portion of society that the private sector, naturally, saw as an opportunity.

[codetrap]

http://www.calgaryherald.com/news/politics/Limiting+private+MRIs+Alberta+table+when+doctors+group/8875563/story.html


Albertans with non-urgent needs can now wait as long as nine months for magnetic resonance imaging at one of 25 publicly-operated scanners. But they can normally get an appointment within a week at one of the 13 private machines in the province if they can afford to pay fees that often top $750.

I was classified as non-urgent despite being barely able to walk and in constant, almost debilitating pain. Don't worry about being able not to sleep, or how it's affecting the rest of your body, or the shitty quality of life. It's not urgent.