First step in privatizing healthcare?

[Mad Mike]

IMHO Shouldice is a bad example. They pioneered a procedure, that you can now get at any Ontario hospital, maybe by a Shouldice trained DR.
... but at any other hospital you'll get operated on by a "general" surgeon, that does lots of other procedures, which is better use of a surgeon.
We already have "specialist" hospitals: if you need complicated eye surgery, you're going to Toronto Western (where you'll probably get cut by a Cuban from Havana), if you need complicated brain surgery on a rocket scientist, you're going to Western, you want nuclear medicine? Go see my nephew at McMaster.
What Shouldice has that makes it work is a workable business plan. They have a product, they know how to deliver the product, and they're good at it.
My father had his hernia's done at Shouldice, 50 yrs ago, paid for by OHIP. When I had my hernia's done, I was offered Shouldice (I didn't go, I should have. I had mine done in the era of the "mesh")... but I betcha we weren't getting he same level of care as a Saudi prince at Shouldice.
Shouldice doesn't control a lot of their costs. They're buying the same operating tables as Ontario, they're buying the same doctors as Ontario, their building costs are probably higher than Ontario... the difference is the management.
Doug Ford can't control the fixed costs of Ontario medical, but he CAN control the management... so isn't Doug Ford wanting to privatize medical in Ontario mean that Doug Ford admits he can't manage a large conglomerate like Ontario medical... BUT the answer is Doug Ford's cronies or American corporations.
That doesn't even come close to making sense. Is Doug Ford bringing us privatized medicine, Doug Ford admitting defeat and throwing in the towel, and his defeat is going to put us in a irreversible situation
... or is is Doug Ford telling us backhandedly that there is a killing to be made in privatized medicine, which backhandedly tells us he knows we're getting hosed and if we privatize we'll get more hosed.
If "privatized" medicine can hire better management that can cut costs, why can't premier Doug? If "privatized" medicine can make a profit in Ontario, doesn't that mean there is currently mis-spending in the system.
...and if "privatized" medicine is the "answer", why are medical cost in America, and their privatized medicine, 2-3 times what it is here.

Tommy Douglas brought us socialized, one pocket medical care, with equal access for all... and that's a big part of what Canada is. I don't think Doug Ford should change that. We should put our efforts into fixing what we got... and what we got is we're drowning in "administrators" and political appointments.

Parts of healthcare that are private are today are saving taxpayers and delivering fast dependable service. Ever waited for an xray or ultrasound? Likely not, that part of imaging is privatized. Those clinics arent allowed to provide MRIs... ever wait for one of those?

 

[backmarkerducati]

Parts of healthcare that are private are today are saving taxpayers and delivering fast dependable service. Ever waited for an xray or ultrasound? Likely not, that part of imaging is privatized. Those clinics arent allowed to provide MRIs... ever wait for one of those?

????? I have used a private MRI in Mississauga covered by OHIP.

 

[sburns]

????? I have used a private MRI in Mississauga covered by OHIP.

Yeah so have I, lots of X-Ray labs, and MRI's are private clinics and covered by OHIP.
Is this is also how dr's make extra coin by opening these clinics and referring you to them?

 

[nobbie48]

Yeah so have I, lots of X-Ray labs, and MRI's are private clinics and covered by OHIP.
Is this is also how dr's make extra coin by opening these clinics and referring you to them?

This is a potential problem. In the USA a judge was found to be dishing out heavy sentences with the prisoners going to a prison where he had shares.

How do we stop unethical MDs from prescribing tests or even drugs that aren't necessary?

However I like the blood test system we have. The next morning I have the results on my computer with abnormal readings highlighted.

One particular thing that bothers me is not knowing what a procedure is costing. What do blood tests cost OHIP?

How much is an MRI on a knee?

As we age we get problems. Are people chasing cures to pains that are a normal part of aging? At what cost?

 

[GreyGhost]

This is a potential problem. In the USA a judge was found to be dishing out heavy sentences with the prisoners going to a prison where he had shares.

How do we stop unethical MDs from prescribing tests or even drugs that aren't necessary?

However I like the blood test system we have. The next morning I have the results on my computer with abnormal readings highlighted.

One particular thing that bothers me is not knowing what a procedure is costing. What do blood tests cost OHIP?

How much is an MRI on a knee?

As we age we get problems. Are people chasing cures to pains that are a normal part of aging? At what cost?

I would love if our health care system gave us a receipt at the end of each doctor/hospital visit. Gives you an idea of what your ailment cost the system but balance owing is zero.

 

[backmarkerducati]

I would love if our health care system gave us a receipt at the end of each doctor/hospital visit. Gives you an idea of what your ailment cost the system but balance owing is zero.

It is one of those damned if you do damned if you don't things. For many people they may consider the cost, others may want to maximize their bills, just because....

 

[Mad Mike]

I would love if our health care system gave us a receipt at the end of each doctor/hospital visit. Gives you an idea of what your ailment cost the system but balance owing is zero.

I think there are a few fundamental changes that would make things better. The receipt thing would certainly raise awareness and satisfy curiosities -- I doubt it would change behaviors.

I'd like to see a small co-pay for any visit by a person over 16 years old. I'd provide annual checkups and emergency services at no charge, but for for minor things that could be dealt with at home or by a visit to the pharmacy (booboos - bee stings, sniffles) I think it's fair to set a co-pay of $15 for a visit to a GP (deducted from GP's billable service), $75 for a visit to the ER.

 

[GreyGhost]

It is one of those damned if you do damned if you don't things. For many people they may consider the cost, others may want to maximize their bills, just because....

From a practical perspective, cost of hospital visit isn't known until weeks later. Doctors are basically piecework and until they enter everything, you don't know their portion of the bill. For the most part, the system seems like a lot of unnecessary busy work to have doctors spend so much time entering coded piecework. Also creates a hazards of dr adding items to a visit to maximize revenue per patient (and therefore revenue per hour).

 

[GreyGhost]

I think there are a few fundamental changes that would make things better. The receipt thing would certainly raise awareness and satisfy curiosities -- I doubt it would change behaviors.

I'd like to see a small co-pay for any visit by a person over 16 years old. I'd provide annual checkups and emergency services at no charge, but for for minor things that could be dealt with at home or by a visit to the pharmacy (booboos - bee stings, sniffles) I think it's fair to set a co-pay of $15 for a visit to a GP (deducted from GP's billable service), $75 for a visit to the ER.

I'm fine with that too. Even lower is probably fine. $5 GP, $10 WIC and $20 ER would probably make a lot of people think twice. If your problem isn't worth $20, you don't need the ER. Many people would gravitate lower in the pyramid where feasible to save some money. The trickier part is you need a rock solid easily accessible path at zero cost for those that really can't afford the copay. Paying $20 for ER could mean not eating for a few days.

 

[timtune]

I think there are a few fundamental changes that would make things better. The receipt thing would certainly raise awareness and satisfy curiosities -- I doubt it would change behaviors.

I'd like to see a small co-pay for any visit by a person over 16 years old. I'd provide annual checkups and emergency services at no charge, but for for minor things that could be dealt with at home or by a visit to the pharmacy (booboos - bee stings, sniffles) I think it's fair to set a co-pay of $15 for a visit to a GP (deducted from GP's billable service), $75 for a visit to the ER.

I too would be good with but we both know it's the edge of the slippery slope. As each consecutive government gets their peepee caught in a squeeze up goes to the copay, over and over again until poof it's more of a pay your own way.

 

[Mad Mike]

????? I have used a private MRI in Mississauga covered by OHIP.

That's great -- I did not know they had started that. In 2019 I waited 70 days for a rotator cuff scan -- a quick check of the Gov't wait time tool shows it's now down to 2 days locally. I guess those private options can work.

 

[jc100]

I think there are a few fundamental changes that would make things better. The receipt thing would certainly raise awareness and satisfy curiosities -- I doubt it would change behaviors.

I'd like to see a small co-pay for any visit by a person over 16 years old. I'd provide annual checkups and emergency services at no charge, but for for minor things that could be dealt with at home or by a visit to the pharmacy (booboos - bee stings, sniffles) I think it's fair to set a co-pay of $15 for a visit to a GP (deducted from GP's billable service), $75 for a visit to the ER.

For many people without a doctor the ER is where they go for everything. Efficient, no, absolutely not. They shouldn’t be penalized for this though. Not until that side of things is fixed. When it is, the plan you suggest would be fine.

 

[nobbie48]

I think there are a few fundamental changes that would make things better. The receipt thing would certainly raise awareness and satisfy curiosities -- I doubt it would change behaviors.

I'd like to see a small co-pay for any visit by a person over 16 years old. I'd provide annual checkups and emergency services at no charge, but for for minor things that could be dealt with at home or by a visit to the pharmacy (booboos - bee stings, sniffles) I think it's fair to set a co-pay of $15 for a visit to a GP (deducted from GP's billable service), $75 for a visit to the ER.

I seem to remember OHIP once being co-pay at a few percent. Some doctors didn't pursue it in the pre-greed era.

With any company I worked for, any expense I incurred for the company had to be passed by me, making sure it was legit.

OHIP is not free. It's taxpayer funded.

FWIW I did a repair at Sick Kids billing the contractor. Someone in the contractor office got confused and thought they did the work for me. I got the bill instead of Sick Kids, double what I charged. It got reversed.

 

[Mad Mike]

The trickier part is you need a rock solid easily accessible path at zero cost for those that really can't afford the copay. Paying $20 for ER could mean not eating for a few days.

I agree that there should be an income threshold and a policy that nobody is turned away from a WIC or GP if they cannot pay. I don't think the ER should be free for WIC/GP things regardless of income.

Where I lived in the US, there were 24 hour WICS beside every hospital ER. If I showed up to the ER with a sniffle or booboo, I'd have the option of paying the full ticket for their services, or head to a local WIC and where I was fully covered by my health insurance.

 

[backmarkerducati]

That's great -- I did not know they had started that. In 2019 I waited 70 days for a rotator cuff scan -- a quick check of the Gov't wait time tool shows it's now down to 2 days locally. I guess those private options can work.

It has been around for a while, mine was also rotator cuff (both actually) and was back in 2017 or 2018 (years before the pandemic). Waited only a few days. Much of this comes down to your doctor knowing about the options.

 

[Mad Mike]

For many people without a doctor the ER is where they go for everything. Efficient, no, absolutely not. They shouldn’t be penalized for this though. Not until that side of things is fixed. When it is, the plan you suggest would be fine.

I agree somewhat. Quick access to primary care is a problem for many, some because they haven't bothered, some because of GP shortages. I believe this can be dealt with locally, I've seen personally how quickly hospitals can adapt. (Ask anyone with a relative waiting in hospital for LTC, hospitals were fully ready and charging forward to discharge folks Nov 20, the day legislation came into effect).

I was at O/T on Oakville in October, there were 75 people waiting in a hallway overnight to see an ER doctor. I could not believe how many people were prepared to queue all night for a booboo. I saw bee stings, minor cuts and scrapes, a family of 4 with pink-eye. IMO, almost everyone waiting could have visited a pharmacy -- instead they elected to tie up nurses, administrators and doctors in an ER. Sad thing is the hospital didn't seem to care either! The triage nurse could have looked at a bee sting and said 'go home toughguy, it will be better in the morning'

 

[GreyGhost]

I agree somewhat. Quick access to primary care is a problem for many, some because they haven't bothered, some because of GP shortages. I believe this can be dealt with locally, I've seen personally how quickly hospitals can adapt. (Ask anyone with a relative waiting in hospital for LTC, hospitals were fully ready and charging forward to discharge folks Nov 20, the day legislation came into effect).

I was at O/T on Oakville in October, there were 75 people waiting in a hallway overnight to see an ER doctor. I could not believe how many people were prepared to queue all night for a booboo. I saw bee stings, minor cuts and scrapes, a family of 4 with pink-eye. IMO, almost everyone waiting could have visited a pharmacy -- instead they elected to tie up nurses, administrators and doctors in an ER. Sad thing is the hospital didn't seem to care either! The triage nurse could have looked at a bee sting and said 'go home toughguy, it will be better in the morning'

You know the beesting guy (or their family) will be the one to sue for millions when they die a day later. I agree though, triage needs work. Triage needs someone that can competently make decisions on care and tell some people to go elsewhere. As it is, nurses do not have that authority (and I don't know if they have sufficient training?).

Barrie has two paths through the ER. As a patient you may not be aware. Path one is for obvious issues with an obvious path to discharge (eg injury needs xray, cast, discharge), path two is for cases with no obvious fully defined path (my belly hurts). You want to get in path one as you get out hours before the person in path two sees a doctor.

 

[Scuba Steve]

You know the beesting guy (or their family) will be the one to sue for millions when they die a day later. I agree though, triage needs work. Triage needs someone that can competently make decisions on care and tell some people to go elsewhere. As it is, nurses do not have that authority (and I don't know if they have sufficient training?).

Barrie has two paths through the ER. As a patient you may not be aware. Path one is for obvious issues with an obvious path to discharge (eg injury needs xray, cast, discharge), path two is for cases with no obvious fully defined path (my belly hurts). You want to get in path one as you get out hours before the person in path two sees a doctor.

Cambridge hands you a envelope Red, Yellow or Green. Red will get seen quickly Green you might as well go home. They don't tell you this but only takes a few minutes of sitting in the waiting room to see what is happening.

 

[GreyGhost]

Wohoo! it's about time they started to engage the private sector.

I'm not worried about for-profit businesses entering the fray -- OHIP is insurance, it shouldn't take the full burden of delivering healthcare. The gov't already saves a fortune by using private operators for imaging, lab work, dental surgery, rehab transportation services -- that model has proven that replacing the cost of inefficiency and bureaucracy with profit is a winning proposition.

I expect unions will be the first to scream bloody murder (if they haven't already). It's been easy for them to hold gov't hostage, not as easy in the public sector.

As expected unions screaming about the sky falling.

Healthcare unions call on Ford to scrap private surgery plans

Ontario healthcare unions are sounding the alarm after Premier Doug Ford revealed a plan to ramp up private surgeries in Ontario on Monday. Faiza Amin reports.

toronto.citynews.ca

 

[raginduck]

As expected unions screaming about the sky falling.

Healthcare unions call on Ford to scrap private surgery plans

Ontario healthcare unions are sounding the alarm after Premier Doug Ford revealed a plan to ramp up private surgeries in Ontario on Monday. Faiza Amin reports.

toronto.citynews.ca

It will be difficult for them to get into the private clinics.