karlunity Posted February 7, 2009 Report Share Posted February 7, 2009 The Hippie was watching a movie about how bad health care is in the USA and how good it is in Canada. Since I want a honest opinion, I distrust the media, I would like to ask your opinion: How long does it take to get in to see a doctor? If you must go in for an operation, what is the cost and waiting time? Does it take 6 months? What about a dentist? What does it cost for say, new teeth and how long is the time lag? What about the cost of meds? Thanks Karl (By the by we are NOT sick. : ) Quote Link to comment Share on other sites More sharing options...
Gothmog Posted February 7, 2009 Report Share Posted February 7, 2009 Hi Karl, Getting in to see a Doctor is not a big problem,although seeing a specialist might take a little time. The worst feature of our system seems to be the wait times for procedures (operations) and relatively frequent last minute cancellations. There are also many complaints about the difficulty in getting specialized testing, such as MRI scans ... I can pay $1000 for my dog to get one immediately, but I must wait months on end to get that which I am 'entitled' to receive under health care. And of course professional sports teams have no problems getting immediate treatment ... but the rest of us plebs must wait patiently in line, often in pain, possibly handicapped, and some even at risk of dying while waiting. Dental care is a separate issue as it is still privately provided for the most part. I have a dental insurance benefit as part of my job, so the cost is manageable. We do have subsidized drugs as part of our medical plan, but I haven't much info on that. I suppose if you needed enough medication it would start costing you. I have also heard that we tend to approve 'generic' drugs up here rather than the latest whiz bang stuff, and as a result it is cheaper than in the US and more or less works as well. I hope that helps ... as you can see, socialized medecine is not all its cracked up to be by some of us. Quote Link to comment Share on other sites More sharing options...
FC Posted February 7, 2009 Report Share Posted February 7, 2009 I keep hearing about how Australian medicine is falling apart. I hear about the rationing of care too in all the countries with socialized healthcare. Quote Link to comment Share on other sites More sharing options...
karlunity Posted February 7, 2009 Author Report Share Posted February 7, 2009 Thanks fellas. karl Quote Link to comment Share on other sites More sharing options...
Jimro Posted February 7, 2009 Report Share Posted February 7, 2009 One of the things that keeps Canadian medications cheaper than American medications is not that they are generic, it is that the entire Canadian Healthcare System uses it's collective bargaining power to get lower prices from pharmacuetical companies. Here in the States the VA is allowed to collectively bargain the same as GM's healthcare program and all other private insurers. On the flipside the bastards in Congress keep giving in to the Big Pharma lobby so that Medicare/Medicaid CANNOT collectively bargain. Which is why the $4 medications from WalMart are only 4 bucks, collective bargaining power. Jimro Quote Link to comment Share on other sites More sharing options...
AzRednek Posted February 7, 2009 Report Share Posted February 7, 2009 From what I was told by a MD that left Canada and moved to the USA. The level of care is determined on well connected you are and how many palms you're willing to grease if you're not connected. He said in Canada they call it tipping in the USA they call it bribery. One of the things that keeps Canadian medications cheaper than American medications is not that they are generic, it is that the entire Canadian Healthcare System uses it's collective bargaining power to get lower prices from pharmacuetical companies. Jimro Canadian Dr's are forced to choose Rx's from a formulary. USA Dr's can select new meds that have just been introduced that are not available to the average Canadian. Quote Link to comment Share on other sites More sharing options...
swamprat Posted February 10, 2009 Report Share Posted February 10, 2009 And the V.A. choses from a prescribed list. What I need is not available from V.A. So I take 4 drugs to cover the one they don't have. My Doctor at the V.A. could not prescribe oxygen for home use without a consult to the lung specialist. The lung specialist at the V.A. had quit. So I end up waiting for an outside consult (an appointment with a private practice doctor). Then everything had to be send back to the V.A. By the way I flunked every test they gave me. Still waiting to hear! Just glad I have access through my family for O2. Government controled health care is a joke! Start asking around and find out how many really good doctors left Canada for the U.S. Set government pay or the skies the limit. Our good doctors will do the same. Go were the money is. The Hipocratic oath is a joke it's the million dollar oath that guides the medical profression today. Go were the money is! Swamprat Quote Link to comment Share on other sites More sharing options...
Jimro Posted February 11, 2009 Report Share Posted February 11, 2009 AzRedneck, Most drugs are classified into families based on the biochemical pathway that they interrupt. A lot of "new" drugs don't offer any new therapies for Doctors but are simply "me too" drugs that do the same thing as older drugs, but they cost more because they are on patent. For example Prilosec and Nexium. The only difference is that Nexium is chirally pure instead of being a 50/50 mix of enantiomers. They have the exact same effect on the body, but Nexium costs more because it is on patent. Don't get my started on the beta blockers and NSAIDs. Formularies are used in the US as well, and they make a lot of sense in keeping healthcare costs down. The US is one of two industrialized countries that allows drug companies to advertise directly to the consumer. If you knew how much of your medication cost went to advertising you would want to tar and feather the board of directors for Merck, Lilly, etc. The advertisements keep patients asking for "New" drugs because the patient has been lead to believe that "new" is better than "old". I talked to my Father about this, he works for the City of Tacoma and has really good insurance with a minimal co-pay for medication. His on patent prescription for Protonix was still costing the insurance company almost three hundred dollars a month. I explained to him that there were generics available that worked on the exact same biochemical pathway (proton pump inhibition). His co-pay went to single digits, the insurance companies payment went to low double digits, and that is good for everybody except the drug company. Most doctors have a basic understanding of biochemistry, but very few specialize in drug pathways (mainly toxicologists and endocrinologists. and most don't have the time to properly counsel patients about medications other than dosage. A normal family practitioner will have to see more than 30 patients a day just to break even. There is a lot wrong with how we practice medicine in the US, but the fixes are relatively simple (stop drug companies from advertising to the public, tort reform caps on pain and suffering to keep insurance premiums down, drug formularies used to keep cost down) and it doesn't require nationalization along the Canadian or UK model. Jimro Quote Link to comment Share on other sites More sharing options...
FC Posted February 11, 2009 Report Share Posted February 11, 2009 I think Protonix used to be $2000 when it was IV only. Swamprat, you are so right! I heard something interesting- drugs are high here because the socialized countries can't/won't finance drug development, so we get stuck with the task (and the bill). Quote Link to comment Share on other sites More sharing options...
Jimro Posted February 12, 2009 Report Share Posted February 12, 2009 FC, The large part of why drug development happens in the US is because of graduate students. The NIH (the FedGov) gives research grants (that means taxpayer dollars) to universities who are looking for treatments for diseases. Once a promising drug is identified by a research group a Pharmaceutical Company will try to buy the patent to the molecule. Once BigPharma owns the patent for the molecule, the clock is ticking to bring the drug to market. The patent only guarantees a monopoly for seven years. This is why BigPharma lets research universities do initial drug development on the taxpayer dime, because it is more profitable than doing their own research. The only positive role that BigPharma plays in drug development is what is called "Phase 3 Clinical Trials". These are the massive double blind against placebo drug tests that are required for FDA approval. Remember that these trials don't prove that a new drug is better than ANYTHING BUT A PLACEBO. As a result there are VERY few drug trials that actually compare different drugs to treat the same condition. One vivid exception to this rule was the GOVERNMENT FUNDED ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) that compared four blood pressure medicines. All four of the drugs studied in ALLHAT are effective in lowering blood pressure. The study tried to find which was the best choice for starting treatment. Results show that diuretics work best to both lower blood pressure and prevent stroke and some forms of heart disease, including heart attack and heart failure. The newer drugs studied were a calcium channel blocker, an angiotensin converting enzyme (ACE) inhibitor, and an alpha-adrenergic blocker. Study of the alpha-adrenergic blocker was stopped early: Compared with those on the diuretic, those on the alpha-adrenergic blocker had substantially more cardiovascular problems, especially hospitalizations for heart failure. To put is more simply, a generic water pill that cost pennies a dose was more effective and safer than a new on patent drug. We may develop a lot of NEW drugs, but we don't spend a lot of time and effort figuring out if the new drugs are actually better than older drugs. Remember what I wrote earlier about drugs being classified by the biochemical pathway that they disrupt, the vast majority of "new" drugs are not acting on a new biochemical pathway, they are just doing the same thing that an older drug does but with an on patent (and therefore more profitable) chemical formula. The bottom line is that BigPharma is raping the taxpayer and the consumer, and advertising directly to the public to drum up demand for drugs of unknown effectiveness (remember that they just have to be better than a placebo) compared to generics, and sending drug reps directly to your doctors office trying to give him/her a financial incentive to prescribe on patent drugs. My wife told me that with my degree I could make a lot of money as a drug rep, but I cannot do that job BECAUSE I know what is really going on. The number one job requirement for a drug rep isn't a biochem degree, it is attractiveness. This is why college CHEERLEADERS are the number one target for BigPharma recruiters. Jimro Quote Link to comment Share on other sites More sharing options...
AzRednek Posted February 12, 2009 Report Share Posted February 12, 2009 AzRedneck, Most drugs are classified into families based on the biochemical pathway that they interrupt. A lot of "new" drugs don't offer any new therapies for Doctors but are simply "me too" drugs that do the same thing as older drugs, but they cost more because they are on patent. For example Prilosec and Nexium. The only difference is that Nexium is chirally pure instead of being a 50/50 mix of enantiomers. They have the exact same effect on the body, but Nexium costs more because it is on patent. Don't get my started on the beta blockers and NSAIDs. I've used both and was also using Protonix. I couldn't tell difference between Prilosec and Nexium but Protonix was a giant leap forward. Blue Cross Blue shield forced me and the doc to jump through a bunch of red tape but finally approved and paid for a 90 day supply. I've used and abused NSAID's for many years. Seems they work well for me about 6-9 months then they just fry my guts. If I switch brands I see the same improvement for the first 30 days then the beneficial effect begins to wear itself down. Seems to me every doc has his favorite NSAID but every one I've tried seems to work just a bit better than the previous one. There was one exception, I can't recall the name. The drug co's own research showed it didn't work any better than Motrin or Naprocyn. Despite the research they did a massive tv ad campaign. I saw posters in doc'c offices, mouse pads and even a coffee cup with the logo. It didn't do jack except nauseate me and had me begging the doc for pnredesone. The difference in my co-pay was 15 bux for a 90 day supply but it got the attention of BC/BS as I started getting calls from RN's to talk to me about alternatives. When one suggested I could increase my other pain meds and go back to I believe it was called Arthoteck I have refused to deal with BC/BS's managed care nurses. I save them a buck but I have to deal with my tolerance level increasing on the heavy duty stuff. I haven't been able to use any NSAID's for about 18 months, if I get an ok from the gut doc I will try the latest and newest. I don't care what the insurance co. pays as my co-pay will only be another 15 bucks. I seriously doubt under govt controlled health care I would have the liberty to try various NSAID's. The doc would likely be stuck trying to choose from a formulary. Formularies are used in the US as well, and they make a lot of sense in keeping healthcare costs down. The US is one of two industrialized countries that allows drug companies to advertise directly to the consumer. If you knew how much of your medication cost went to advertising you would want to tar and feather the board of directors for Merck, Lilly, etc. The advertisements keep patients asking for "New" drugs because the patient has been lead to believe that "new" is better than "old". I know about the costs to advertise. Former friend of mine was a manufacture's rep for a drug co. Back in the 70's we partied hardy on his expense account. Booze, broads, blowjobs, hotel suites, RV rental and I even got a nice set of boots and a western suit. All I had to do was pose as a non-English speaking Dr from Russia and agree to take a suit case full of free samples home with me. My friend was sharp, "oh he had to work on the collective farm while in medical school" he told his manager after I shook his hand. My friend eventually cooked his brain taking a psych drug that was only approved for use for institutionalized mental patients. He was still in the state's funny farm last I hard. Our friendship ended after drinking a cup of coffee at his apartment and I didn't sleep for 24 hours, even worse I didn't care if I slept. Long story short, he dropped the assault charges against me. Unfortunately the assault charges remain today on a police record and comes back to bite me in the ass every now and then. I never did find out what he spiked the coffee with. I talked to my Father about this, he works for the City of Tacoma and has really good insurance with a minimal co-pay for medication. His on patent prescription for Protonix was still costing the insurance company almost three hundred dollars a month. I explained to him that there were generics available that worked on the exact same biochemical pathway (proton pump inhibition). His co-pay went to single digits, the insurance companies payment went to low double digits, and that is good for everybody except the drug company. I've always used generics as my co-pay is considerably less. I did have problems with one in particular about 6 months ago and I would be willing to pony up the extra bucks if I needed it again. It was a pain killer that was supposed to be good for 8-12 hours. What the generics did was get me higher than a kite for two hours and leave me miserable for the next several hours. The brand name stuff worked like it was supposed to. When the managed care nurse called I wouldn't take her call. I gave her phone # to the pain doc and never heard from her again. Most doctors have a basic understanding of biochemistry, but very few specialize in drug pathways (mainly toxicologists and endocrinologists. and most don't have the time to properly counsel patients about medications other than dosage. A normal family practitioner will have to see more than 30 patients a day just to break even. What is important to me is the Dr knows a hell of allot more than I do. I love the arrogant holier than thou type, simply because they know their business. I trust his judgment and truly believe he will write the best available Rx. There is a lot wrong with how we practice medicine in the US, but the fixes are relatively simple (stop drug companies from advertising to the public, tort reform caps on pain and suffering to keep insurance premiums down, drug formularies used to keep cost down) and it doesn't require nationalization along the Canadian or UK model. I would be pushing daisies if it wasn't for a drug company and an experimental drug. The cancer docs were trying to harvest my stem cells for a transplant after chemo. For numerous reasons and some that are way above my intellect my bone marrow would not produce enough stem cells. I was producing about 2-5 % of normal. After some red tape, some real hard work by two Dr's and threatening Blue Cross with legal action if they didn't pay for the treatment related to the experimental drug, not the drug itself. I finally qualified for the program and agreed to be a guinea pig for research. The drug worked. With in a few weeks I was producing sufficient stem cells, did the transplant and survived. A Nurse working for the City of Hope told me each dose of the experimental drug was worth 6 figures. When the hospital's phamicist, accompanied by a security guard carries the drug and stayed with me untill the nurse emptied the syrenge in me you have to know it was worth mega bucks. I got it no charge. I'm dealing with some undesirable side effects and the unknown but it was worth it as I'm still alive and rambling away at you guys via my keyboard. As far as I'm concerned I hope the drug company continues to pad it's expense on other drugs to finance continuing research on other new life saving and quality of life meds. I wonder if under the Canadian system if I would have qualified or even been considered for similair treatment. I seriously doubt it. Geez Jimro can't believe I wrote all that!! Quote Link to comment Share on other sites More sharing options...
tinkerfive Posted February 13, 2009 Report Share Posted February 13, 2009 My wife told me that with my degree I could make a lot of money as a drug rep, but I cannot do that job BECAUSE I know what is really going on. The number one job requirement for a drug rep isn't a biochem degree, it is attractiveness. This is why college CHEERLEADERS are the number one target for BigPharma recruiters. Jimro I see plenty of drug reps. I'd say 60/40 female but few are 'cheerleader' attractive. Unless you are grotesque and or have an objectionable personality I think that you might do well because I think that a lot of doctors would appreciate getting their information from one who knows from where he speaks Vs. someone who can merely regurgitate what they were told at a sales seminar. There is one guy who is heavy and bald, he does alright. Tinker Quote Link to comment Share on other sites More sharing options...
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