Idea of fast-tracking surgery for visitors from U.S. discriminates against Canadians in their own country
Some ideas are not as wacky as they seem. Health Minister Kevin Falcon’s suggestion that we look at ways to turn part of our health care system into a gold mine is not one of these ideas. On closer examination it is just as wacky as it appears at first blush.
MANILA, Philippines—Industry players in Malaysia’s medical tourism are undertaking a variety of measures to welcome the expected surge of Singaporeans seeking medical treatment and therapies there.
One of the unmentioned or seldom mentioned attributes of socialized medicine in the US is the component that if US health care becomes socialized and further limited down the line either in actuality or if the comparison either in cost or absolute comparison leads to a decline in customer service levels then a major option and stop gap to those waiting in line in other countries , those who do not want to wait or those who wish a higher caliber of medical service at home – and are willing to pay or sacrifice to pay – becomes less if not available.
In socialized medicine what happens over time is that the system responds to itself , not to the ultimate customer. The doctor , who was previously the head of the team , on in previous – pre team work times – was the absolute power and arbitrage. Not so in socialized medicine. The doctor answers to the clinic that employs him or her , or to bureaucrats not to the consumer. On top of that it is not as if the medical consumer has a choice. Imagine a medtravel tourist complaining in writing to an address . The bureaucrat /s could care less. Their concern is their budget , their charts and graphs. On top of that their biggest responsibility is not to get their boss or themselves in trouble or draw attention to themselves.If a letter or email arrives – so what . That person lives far away. they cannot even vote or complain to the health minister or political party leaders – who cares. Its a matter for the medical bureaucratic system to put in time for its pension , go to lunch go home at 3:30 – stop the work on the graphs and charts at 2:30 p.m. Thats about it. On top of that to pretend and actually believe in their mind and heart of hearts that the world and especially the medical system functioning is dependent on them and their unique and powerful administrative skills.
After all the less resources available in the end after pilfering the medical system of funds , the more the need for more administration to parcel out those limited resources in the medical and healthcare systems.
We need accountability in health care notes a grass roots Canadian campaign newsletter.
The self written and distributed newsletter notes that “….. then there is the “stupid” decision to cut back on emergency services at the Seven Oaks Hospital in Winnipeg Canada. It seems that after a major update to the emergency department of this major regional medical center’s emergency department that the working hours of the emergency department were cut back. Talk about the left hand not knowing what the right hand was doing – in plain site. The amazing part is that even with press releases on the openings of the updated unit complete with a ribbon cutting ceremony and a how to reach pdf being written and offered on the actual hospital website the cutbacks went into place.
Phase 1 of the new Seven Oaks Hospital Emergency Department is now complete. A Ribbon Cutting Ceremony officially opening the new facility was held on August 19.
“This state-of-the-art department was designed to ensure we can provide our citizens with the best emergency care possible,” said Health Minister Theresa Oswald. “This expanded emergency department means improved care for patients and their families, and a better work environment for our health-care professionals.”
Please see the attached .pdf files for information on the new facility and Press Release.
| Attachment | Size |
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| When To Go To The ER.pdf | 91.71 KB |
| New Emergency Department Ribbon Cutting.pdf | 297.45 KB |
| Press Release August 18 2008.pdf | 100.58 KB |
If one looks at a map of the coverage area of the catchment areas of the Seven Oaks Hospital (SOGH) is clearly visible. There are no other major regional medical centers what so ever in the adjacent local and rural areas just north of the only major center in this very large geographic areas of the Province of Manitoba.
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Manitoba is the easternmost of the three Prairie Provinces. Comparatively level, Manitoba generally ranges from 490-ft./150 m to 980-ft./300 m above sea level. Baldy Mountain is Manitoba’s highest point, at 2727 ft./831 m. Agricultural land lies in a triangle, bordering Saskatchewan and the U.S., cutting diagonally across lake Winnipeg. The northern 3/5 of Manitoba is Precambrian Shield. In northernmost Manitoba lies tundra and permafrost (permanently frozen subsoil). All waters in Manitoba flow to Hudson Bay. Before settlement, a large area of southern Manitoba was flood plain or swamp. An extensive system of drainage ditches had to be constructed throughout south central Manitoba to make the region suitable for cultivation. |
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source: http://www.travelmanitoba.com/default.asp?page=130&node=585
Further the writer of this article notes: ” Cutting back these emergency services goes against the concept of community based hospitals, which if managed properly are more cost effective and can provide the same level of care as the Health Sciences Center ( the major teaching hospital and medical center in the major and dominant city of Winnipeg in the whole Canadian Province of Manitoba ).
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820 Sherbrook Street Winnipeg, Manitoba, Canada R3A 1R9 |
| About HSC | Departments | Research/Education | Volunteers | Working at HSC | Site Map |
 Search the HSC website |
Tuesday, April 28, 2009 |
source: http://www.hsc.mb.ca/ The writer of the pamphlet goes on to say “ What I have found over the last few weeks , and time period, is that many healthcare workers ( in the City of Winnipeg and Manitoba Canada areas), in general , are very opinionated about the Winnipeg Regional Health Authority (W.H.R.A.).
287 Broadway
Winnipeg, MB R3C 0R9, Canada
    (204) 926-6000
Medical Tourism Medical Tourism
287 Broadway
Winnipeg, MB R3C 0R9, Canada
(204) 926-6000 |
Canadian Doctor: Shortages So Bad North Of The Border Some Towns … – Dr. David Gratzer, writing in the Wall Street Journal, also makes a good point about just how dependent the Canadian health care system is on America’s. Indeed, Canada’s provincial governments themselves rely on American medicine. …
Why we need a public options for health care and debunking … – Every time we try to have a discussion about a public single payer option we hear how we shouldn’t have it and Canada as used as an example of how bad public health care options are. This article debunks the myths surrounding Canadian health … As a Canadian living in the United States for the past 17 years, I am frequently asked by Americans and Canadians alike to declare one health care system as the better one. The article continues, debunking myths about Canadian …
Wash Park Prophet: Canadian Health Care Works – The things that work in the Canadian health care system are explained here. I suspect, although the article does not say so, that in addition to having lower administrative costs and saving money with preventantive care, that many providers are also paid less richly in Canada than in the United States (although providers in Canada have essentially no bad debt losses, while American providers are swimming in bad debt). Posted by Andrew Oh-Willeke at 6/09/2009 12:08:00 AM …
Hungarians Bribing Doctors Increases Health Spending (Update1)
By Alex Kuli
Aug. 28 (Bloomberg) — For Magdolna Vincze, free health care was never so expensive.
When giving birth to her second son in 2004, her payroll contributions into the state insurance system weren’t enough to guarantee the medical care she needed, she said. So Vincze did what she said is expected of patients: She bribed staff at Budapest’s Szent Margit hospital more than 100,000 forint ($522), about a month’s take-home pay for the average Hungarian.
“Everyone knows it’s unethical,” says Vincze, a 34-year-old telephone company worker. “People feel pressured. They’re afraid they won’t get personal attention, the doctor won’t even look at them, the nurses won’t go into the room, they won’t tell them about the newest treatments.”
Hungarians grew up giving communist-era doctors what they call “gratitude money” to secure comforts not provided by the state. Hungarians now pay doctors as much as 100 billion for int under the table a year, Health Minister Agnes Horvath says. The practice inflates Hungary’s health budget as doctors prescribe unnecessary procedures in hopes of maximizing illicit income, she says.
The debate over bribery comes as the government proposes changes to the way health care is funded and paid for. Medical spending affects the country’s battle against the European Union’s widest budget deficit, which reached 9.2 percent of gross domestic product last year.
The shortfall forced Hungary to abandon plans to adopt the euro as its currency by 2010. Overspending on health alone last year was equivalent to about 2 percent of GDP, according to the Health Ministry’s Web site.
Acceptable, But Unfair
About 60 percent of Hungarians consider medical bribery acceptable, though nearly all of them say it’s unfair, according to an opinion survey published July 24 by Median, a private Budapest polling agency. More than a third would ban it, the poll showed.
Horvath’s measures to fight bribery include a 300-forint fee for doctor’s visits, which used to be free. Patients who pay a fee are less likely to slip cash to the doctor, she said.
Ferenc Odor, a member of the main opposition party, Fidesz, instructed hospitals July 31 to post Horvath’s picture on machines where patients pay the fee, according to a party Web site.
“People should know who to thank,” the statement said.
Horvath’s party, the Free Democrats’ Alliance, responded by asking Odor to provide patients with bribery envelopes bearing a picture of Fidesz leader Viktor Orban.
Stay Awhile
Some doctors prescribe unnecessary hospital stays because overnight patients are more likely to hand out cash, Horvath said. Slightly more than 2 percent of surgeries were performed on an outpatient basis in Hungary in 2004, compared with 53 percent in Britain and 48 percent in the Netherlands, according to the Health Ministry’s Web site.
Doctors hate taking cash and prescribing unnecessary treatments, says Geza Gyenes, chief secretary at the Hungarian Doctor’s Chamber. The problem is, doctors are underpaid, with some earning a base pay near minimum wage, he said.
“An assistant bricklayer gets paid better than a doctor,” Gyenes says. “If we didn’t have gratitude money, not one doctor would have stayed in this country” after communism collapsed, he said.
Still, many doctors are well paid, and bribes exacerbate income differences, says Finance Minister Janos Veres.
“Who gets the most gratitude money? The professor at the clinic, whose income isn’t low,” Veres says. “Who gets the least? The coroner in the mortuary, even though his salary is low.”
Commonplace
Medical bribery remains commonplace in the east 17 years after communism collapsed, former Dutch Health Minister Hans Hoogervorst, who served as an adviser to Hungary’s health ministry earlier this year, said at a June 14 press conference.
Latvian President Valdis Zatlers, a surgeon, told the Diena newspaper in May that he’d received under-the-table gifts from patients during his 27-year career. He didn’t specify when, or how much he’d received. He was fined 250 lati ($495) in July in connection with an incomplete tax declaration, state revenue service spokeswoman Agnete Busta said.
The city of Budapest, which owns Szent Margit and other hospitals, doesn’t have the wherewithal to eliminate gratuities, Deputy Mayor Csaba Horvath said July 20.
“It’s impossible to change a 40- to 50-year-old practice from one day to the next, that’s why banning it wouldn’t be effective on its own,” says Horvath, who is no relation to the health minister.
Options
Criminalizing the practice will only drive it underground, Health Minister Horvath says. Instead, the ministry has implemented rules to ensure patients don’t bribe their way to the front of a waiting list, she said.
In June, she awarded 3.3 billion forint to institutions to build outpatient surgery facilities. Hospitals can save an estimated 814 million forint a year by not requiring patients to stay overnight for certain operations, Horvath said at an Aug. 9 press conference.
Hungary’s program to overhaul health insurance may help to eliminate bribes, says Mihaly Kokeny, a member of Parliament who heads the Health Committee. By 2009, the state will break its single health insurer into several funds with minority private ownership. The funds will choose which hospitals they’ll contract with and may stay away from the ones they deem corrupt, he says.
Competition between providers has eliminated coercive tipping in other formerly communist industries, such as gas stations, said Zsombor Kovacsy, president of the Hungarian Health Insurance Supervisory Authority.
“Without gratitude money, they filled your car with petrol, but didn’t clean it at all,” he said in a May 21 interview. “Now, I never give gratitude money to the petrol station guys, and they do everything. So I think that the mentality of competition and well-regulated procedures can help a lot.”
Polling data shows that Slovakia discouraged bribery after it introduced visit fees similar to Hungary’s in 2003, said Tomas Szalay, a partner at the Health Policy Institute in Bratislava, Slovakia.
Patients “pay cash and feel that it isn’t for free,” he says. “Why should they give something more?”
To contact the reporter on this story: Alex Kuli in Budapest at akuli@bloomberg.net
