Re: The Death of the Canadian Model
From: Seele, Mona (Mseele@tmh.tmc.edu)
Tue Feb 28 09:40:11 2006
That is a myth perpetuated by personnel who want a stick to hold over the patient's head to prevent them from leaving ama. The insurance company is obligated to pay and cannot hold a payment simply because the patient left ama.
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Jamie
Sent: Monday, February 27, 2006 9:33 PM
To: Multiple recipients of list OB-GYN-L
Subject: Re: The Death of the Canadian Model
Don't forget that insurance companies can deny to pay for the entire hospitalization if the patient leaves AMA
At Mon, 27 Feb 2006, fran wilson wrote:
>
>>>>>I couldn't begin to imagine emptying beds because the state said I
>>>>>had to.<<<<
>Yesterday I went to discharge a patient from the hospital. The patient and baby were fine and ready to go. The pediatrician declined to discharge the baby because it was evening and mom was a primip. At other times, when the unit is busy, the nurses call us and request that we discharge our patients to free up rooms. When we are not busy the nurses discourage us from discharging patients because they don't want to get sent home for low census or floated to a medical or surgical unit. The hospital has also warned us that when census is low, we should consider keeping patients longer so the revenue is not affected (not in exactly those words<G>).
>There are lots of reasons that we keep or discharge patients that have
>nothing to do with the stability of the patient. I think saving the taxpayers a few bucks is not the worst reason in the world. Most of my OB patients are anxious to get out of there back to the comfort of their own home. The babies are essentially being held hostage by the new pediatricians who have no faith in the parents or their own ability to tell a healthy baby from a sick one. And if they parents ask to leave AMA, which is their right, the nurses scare the heck out of them by telling them "well, if the baby gets sick and dies it will be your fault" and vague threats of talking to "
find a new provider for the baby.
>Fran Wilson CNMKennewick, WA
>
>From: "William McIntosh" <wdmcintosh@charter.net>Reply-To:
>ob-gyn-l@obgyn.netTo: Multiple recipients of list OB-GYN-L
><ob-gyn-l@dns.obgyn.net>Subject: RE: The Death of the Canadian
>ModelDate: Mon, 27 Feb 2006 10:18:20 -0600I did a Gyn Onc rotation in
>Canada while I was a resident, as we did nothave much of a cancer service. It was a wonderful experience, and the carewas top notch by and large, but I was jarred by one thing. During morningrounds one day, the chief of service asked which 2 patients could be senthome that day. I was stumped as no one was actually medically ready to gohome, though some were ready for hospice care. I was told that theProvincial authority had decommissioned 2 Onc beds, and we had to emptythem. We transferred 2 terminal patients either home or to hospice, I don'tremember which. This was the only source of gyn onc care in the province(another bizarre thing from my perspective. I mean really, flying athousand miles for a colpo!?) I am not sure what was happening. I couldn'tbegin to imagine emptying beds because the state said I had to. I stillcan't.I loved my time there, and I learned so very much from the wonderfulattendings I had, but it gave me a very jaundiced view of single-payermedical models. If there is no competition, there is no incentive toimprove. Good intentions are not enough.William D McIntosh, MD, FACOGClarksville, TN-----Original Message-----From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of artfougner, mdSent: Monday, February 27, 2006 7:05 AMTo: Multiple recipients of list OB-GYN-LSubject: Gen: The Death of the Canadian ModelProponents of single-payer health care reform in the United States havelong pointed toward Canada as a model for the US to emulate.The New York Times reports that the Canadian system is imploding. Arecent Candian Supreme Court decision allowed private health care (oh,the shame, the horror) and as a result, Canadians tired of waiting forradiation therapy,
dprivate alternatives springing up under the new legal environment.The Times reports:Canada remains the only industrialized country that outlaws privatelyfinanced purchases of core medical services. Prime Minister StephenHarper and other politicians remain reluctant to openly propose sweepingchanges even though costs for the national and provincial governmentsare exploding and some cancer patients are waiting months for diagnostictests and treatment.But a Supreme Court ruling last June - it found that a Quebec provincialban on private health insurance was unconstitutional when patients weresuffering and even dying on waiting lists - appears to have become aturning point for the entire country."The prohibition on obtaining private health insurance is notconstitutional where the public system fails to deliver reasonableservices," the court ruled.The key paragraph:The country's publicly financed health insurance system - frequentlydescribed as the third rail of its political system and a core value ofits national identity - is gradually breaking down. Private clinics areopening around the country by an estimated one a week, and privateinsurance companies are about to find a gold mine.Posted by Russell Roberts in Healthhttp://cafehayek.typepad.com/hayek/2006/02/the_death_of_th.htmlArt--art fougner, mdSupport Free SpeechBuy Danish!
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JFields, RN, BSN
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