PDA

View Full Version : Economics Canada healthcare costs sky rocketing...so much for looking to them as an example


mlyonsd
06-02-2010, 02:23 PM
Soaring costs force Canada to reassess health model

<CITE class=vcard>By Claire Sibonney - Analysis Claire Sibonney - Analysis </CITE><ABBR class=timedate title=2010-05-31T11:38:23-0700>Mon May 31, 2:38 pm ET</ABBR>
<ABBR class=timedate title=2010-05-31T11:38:23-0700></ABBR>
TORONTO (Reuters) Pressured by an aging population and the need to rein in budget deficits, Canada's provinces are taking tough measures to curb healthcare costs, a trend that could erode the principles of the popular state-funded system.

Ontario, Canada's most populous province, kicked off a fierce battle with drug companies and pharmacies when it said earlier this year it would halve generic drug prices and eliminate "incentive fees" to generic drug manufacturers.


British Columbia is replacing block grants to hospitals with fee-for-procedure payments and Quebec has a new flat health tax and a proposal for payments on each medical visit -- an idea that critics say is an illegal user fee.

And a few provinces are also experimenting with private funding for procedures such as hip, knee and cataract surgery.

It's likely just a start as the provinces, responsible for delivering healthcare, cope with the demands of a retiring baby-boom generation. Official figures show that senior citizens will make up 25 percent of the population by 2036.

"There's got to be some change to the status quo whether it happens in three years or 10 years," said Derek Burleton, senior economist at Toronto-Dominion Bank.

"We can't continually see health spending growing above and beyond the growth rate in the economy because, at some point, it means crowding out of all the other government services.

"At some stage we're going to hit a breaking point."

MIRROR IMAGE DEBATE
In some ways the Canadian debate is the mirror image of discussions going on in the United States.

Canada, fretting over budget strains, wants to prune its system, while the United States, worrying about an army of uninsured, aims to create a state-backed safety net.

Healthcare in Canada is delivered through a publicly funded system, which covers all "medically necessary" hospital and physician care and curbs the role of private medicine. It ate up about 40 percent of provincial budgets, or some C$183 billion ($174 billion) last year.

Spending has been rising 6 percent a year under a deal that added C$41.3 billion of federal funding over 10 years.

But that deal ends in 2013, and the federal government is unlikely to be as generous in future, especially for one-off projects.

"As Ottawa looks to repair its budget balance ... one could see these one-time allocations to specific health projects might be curtailed," said Mary Webb, senior economist at Scotia Capital.

Brian Golden, a professor at University of Toronto's Rotman School of Business, said provinces are weighing new sources of funding, including "means-testing" and moving toward evidence-based and pay-for-performance models.

"Why are we paying more or the same for cataract surgery when it costs substantially less today than it did 10 years ago? There's going to be a finer look at what we're paying for and, more importantly, what we're getting for it," he said.

Other problems include trying to control independently set salaries for top hospital executives and doctors and rein in spiraling costs for new medical technologies and drugs.

Ontario says healthcare could eat up 70 percent of its budget in 12 years, if all these costs are left unchecked.

"Our objective is to preserve the quality healthcare system we have and indeed to enhance it. But there are difficult decisions ahead and we will continue to make them," Ontario Finance Minister Dwight Duncan told Reuters.

The province has introduced legislation that ties hospital chief executive pay with the quality of patient care and says it wants to put more physicians on salary to save money.

In a report released last week, TD Bank said Ontario should consider other proposals to help cut costs, including scaling back drug coverage for affluent seniors and paying doctors according to quality and efficiency of care.

WINNERS AND LOSERS
The losers could be drug companies and pharmacies, both of which are getting increasingly nervous.

"Many of the advances in healthcare and life expectancy are due to the pharmaceutical industry so we should never demonize them," said U of T's Golden. "We need to ensure that they maintain a profitable business but our ability to make it very very profitable is constrained right now."

Scotia Capital's Webb said one cost-saving idea may be to make patients aware of how much it costs each time they visit a healthcare professional. "(The public) will use the services more wisely if they know how much it's costing," she said.

"If it's absolutely free with no information on the cost and the information of an alternative that would be have been more practical, then how can we expect the public to wisely use the service?"

But change may come slowly. Universal healthcare is central to Canada's national identity, and decisions are made as much on politics as economics.

"It's an area that Canadians don't want to see touched," said TD's Burleton. "Essentially it boils down the wishes of the population. But I think, from an economist's standpoint, we point to the fact that sometimes Canadians in the short term may not realize the cost."

($1=$1.05 Canadian)
(Reporting by Claire Sibonney; editing by Janet Guttsman and Peter Galloway)
http://news.yahoo.com/s/nm/20100531/hl_nm/us_health_3

The Mad Crapper
06-02-2010, 02:25 PM
Awesome!

HonestChieffan
06-02-2010, 02:29 PM
How can this be? nationalized HC is saving us money.


right?

mikey23545
06-02-2010, 02:46 PM
Kotter (or one of his drunken mults) will be along shortly to explain it all to you...

The Mad Crapper
06-02-2010, 02:54 PM
Kotter (or one of his drunken mults) will be along shortly to explain it all to you...

ROFL

Bwana
06-02-2010, 05:19 PM
Kotter (or one of his drunken mults) will be along shortly to explain it all to you...

:LOL:

Nice

googlegoogle
06-02-2010, 07:13 PM
Kotter's family had a medical crisis so i can understand his dilemma.

Doctors are in limited supply in these systems. No one wants to become a doctor. Most docs are in it for some money.



The costs aren't drugs like the 'free health care' people want you to believe. It's the cost of Hospitals, unions and doctors. Most of them have tried to slow down competition.

It's a system that will always spiral into debt. People think it's free and aren't told the price therefore they visit their doctors more often.

Google singapore healthcare for some solutions. We also need to remove the 8 year process to become doctors and create more market solutions which don't happen in medicare and medicaid.

Saul Good
06-02-2010, 09:32 PM
The market is already creating solutions. High deductible plans and the expansion of minute clinics are the wave of the present/future.

BucEyedPea
06-02-2010, 10:07 PM
The market is already creating solutions. High deductible plans and the expansion of minute clinics are the wave of the present/future.

There's even medical service online now too! Who woulda' thought!

Telemedicine:
Dr. Jerry Jones uses two-way video at his home in Houston to consult with a patient across town. Dr. Jones is under contract to NuPhysicia, one of the new telemedicine companies.

http://graphics8.nytimes.com/images/2010/05/30/business/JPTELEMED/JPTELEMED-articleLarge.jpg

http://www.nytimes.com/2010/05/30/business/30telemed.html?src=busln&pagewanted=all





http://www.nytimes.com/2010/05/30/business/30telemed.html?src=busln&pagewanted=all

bluehawkdoc
06-03-2010, 10:10 AM
Doctors are in limited supply in these systems. No one wants to become a doctor. Most docs are in it for some money.

This cracks me up. I'm sure the magnanimous googlegoogle works for free. If your education costs you 8+ years and >$125G, you might need "some money" to pay it back.:shake:

googlegoogle
06-03-2010, 03:50 PM
This cracks me up. I'm sure the magnanimous googlegoogle works for free. If your education costs you 8+ years and >$125G, you might need "some money" to pay it back.:shake:

You're right. I didn't explain my position. I want free markets. The AMA does control the supply of doctors. I also failed to mention hospitals are big part of the problem and their lack of transparency and pricing.
http://wallstreetpit.com/5769-the-medical-cartel-why-are-md-salaries-so-high

There's something wrong that it costs a quarter of a million to become a doctor.

bluehawkdoc
06-03-2010, 04:46 PM
The AMA is a joke right now. Those that shape policy in the organization don't represent the base. What's new, right?