All of US.... a thought for a Tuesday

[bluemic]

On 2017-02-02 at 2:07 AM, Kip Powick said:

I ask one other thing.......no Provincial l Governmental medical assistance until you have paid TAXES for , 1,2,3,4,5, years. (reader..take your pick)

I don't normally get into these types of discussions mostly because, like so many other topics, there is really no 'correct' solution.  One discovers these little truths the older one gets I'm finding.

But Kip, how would you address the hypothetical issue of say, a recent immigrant finding him/herself the victim of a vicious assault?  Or being diagnosed with a serious disease?  Does a family member have to show up at emerg with a recent T4 slip in order to commence treatment?  And failing being able to produce said T4, does the hospital say, "Sorry"?  Followed by, "Next!"

Nothing is ever black and white'...

[boestar]

The problem here is that you are all placing the burden of the system on the TAXPAYER.  the problem with the system is with the Government Management of it.  Our Governments, both Provincial and National waste more money ignoring the issues than they do fixing them. Healthcare is the primary example   The system is not broken the management of the system is.

As for who should have access to healthcare and when.  Well ANY doctor has the responsibility to provide care no matter what.  Our system ensures that this is the case.  Sure is some places, especially "SmallTown" Canada they have problems getting doctors and surgeons to work there.  the issue being that the doctor will not make enough money in "SmallTown" due to the pay schedule for a doctor which is the same no matter where you go.  Where I am we have a hospital but no pediatricians or OBGYN because no one wants to perform those duties in a small town when they can make significantly more money in the bigger centres.

In Canada, if you are a resident, you have the RIGHT to healthcare. Period.  It is one of the things that makes this a great country.

 

[Kip Powick]

3 hours ago, bluemic said:

But Kip, how would you address the hypothetical issue of say, a recent immigrant finding him/herself the victim of a vicious assault?  Or being diagnosed with a serious disease?  Does a family member have to show up at emerg with a recent T4 slip in order to commence treatment?  And failing being able to produce said T4, does the hospital say, "Sorry"?  Followed by, "Next!"

Nothing is ever black and white'...

I think we all know there are exceptions to any rule....an EMERGENCY is an emergency but colds, flu and the like are not. 

I know nothing is ever just black and white,(although the old artificial Horizon you and I both used was...and we survived), but something has to be done to bolster the present Health system and unless there is a boat load of cash handed over by the Feds, we have to start somewhere to cut costs.

I would also offer that perhaps Dr. Appts should cost a minimum (say $5-10.00) every time you make an appointment to see one. I can recall, when stationed in NS many years ago, our GP charged $2.00 every time we took a child in to see him. Like any government service, there are those that take advantage of what is available and are very adept at finding loop holes in regulations we all abide by. Should we have a two tier Health system ??

If Health services  keep declining  at the rate we seem to see, even  though Dagger disagrees, I would think that might be coming.  

PS....To show medical treatment qualifications out here we don't use T4 slips, we have Health Cards that one has to wait 3 months for when arriving in the "Hub" of Canada. Perhaps BC should upgrade their program ....

Have a nice weekend.....

 

[dagger]

8 hours ago, Kip Powick said:

Yes Dagger.....

....................... and on which you have drawn ................................

True, I have drawn, and am drawing, OAS and CPP and I did contribute to those funds my entire working life. I also paid into UI and never drew a cent from that fund.

I also know where you live but out here in "Smalltown" we have seen our hospital turn into a clinic....not short of funds...really?? My son has had his gallbladder surgery postponed 3 times and he lives in a "Bigtown", my wife can't see a specialist for over a year.

I really don't give a damn about the Gardner Expressway, nor the bridges in Montreal, I use neither. Your rant about infrastructure has nothing to do with  my opinion concerning paying taxes BEFORE you start using the health system which is OPEN to everyone who settles in this country. 

PS...you want to fix the infrastructure in your town.......how about user pay??? Seems to be the flavour of the day for all those things that used to be free and I have no objections to that source of revenue.

PPS...Here in "Smalltown", those of us on the City water and sewer system are paying an add-on fee to help pay for all the new work that is being done...I don't have a problem with that.

1. First, a technical point: OAS is not a fund, like CPP. No newcomer qualifies for either. OAS is not a fund, it is paid for out of general revenues and based on period of residence in Canada, and CPP is based on contributions made by you and employers. So no pensions for newcomers. UI is insurance, and it's wonderful that you have never drawn. I drew a few cheques about 30 years ago, but have paid in more than I received. I can say the same for all of the insurance I pay and have paid for. It covered me all along, so I could drive places without fear of having an accident that would result in a lawsuit draining all my savings. Paying into something for insurance means you were getting something all along. I have homeowner's insurance on which I have never made a claim, but that doesn't mean I have a special entitlement based on past payments. I have to keep paying in to get my coverage.

2. As I said about hospitals, yes, smaller communities have it tougher. Sorry about your son's gall bladder, I don't know the circumstances of the postponements, but I do know from my own experiences that the system has worked well for both myself and my wife. Again, I paid in to have the availability of coverage. My taxes paid in the past weren't buying future coverage or protection, they were buying current coverage. I paid taxes, and my OHIP services drawn were covered out of current tax revenues. Most everything we pay taxes for brings a form of immediate quid pro quo, not some future quid pro quo. I think many people like to acknowledge that they were getting something all along, they like to make you think it earned them a future entitlement. It didn't and it doesn't. (One can have a good discussion about whether health care should be funded like insurance, with younger people paying for coverage they don't draw much from in order to get the deferred benefit of comprehensive coverage in later decades when they will draw on it much more - that's effectively what the US has, but it's not how my province's plan operates.)

3. Many immigrants, maybe most, earn some money virtually from the get-go, whether it's bagging groceries in an ethnic super market, driving a taxi or Uber, collecting baggage trollies at the airport, working night shift cleaning toilets in hospitals or hotels, etc. And if a relative gives them some money to spend while they look for a job, it's after tax money that is returned to the economy rather than parked in a 1% savings account.  Moreover, they are admitted into the country as healthy persons, so their draw on provincial health care is likely to be modest, at least until they are paying into the system for a period of time.

4. User pay. I have no problem with that. I would have applied tolls on the road and bridge I mentioned. However, nothing was ever free, just like health care isn't free. That older infrastructure was paid for by tax revenues sufficient to cover their construction cost and maintenance (directed cash flow, or borrowing that had to be repaid). People today don't want to pay for replacing those dilapidated structures. They want someone else to pay for it.

5. User pay again. I, too, pay a supplemental fee for extra water infrastructure upgrading. So does everyone in my city. Again, I have no problem with that. And if the Mayor of my city wasn't already running for re-election - 18 months ahead of the vote - and had the courage to advocate for higher property taxes to pay for necessary additional transit, I'd be all for it, even though I am not likely to use those proposed lines, I am already well served by the subway here. But funding them would be a part of good city-building, so I would support a property surtax for that purpose.
 

[Kip Powick]

Morning Dagger..

 

Thanks for a most civil discussion, (reply).

Yes, you are correct about the terminology concerning  CPP and OAS and I am also sure you are aware that even though I paid into both, being an ex-Govt employee, (Military) , my CPP was reduced in excess of $450.00 when I turned 65. As it stands I am doing fine, good investments,  a low key lifestyle and all is well. Kids all gone and enjoying life and enduring those maladies that one can expect as they age. 

Home Owners and Vehicle Insurance. I happen to deal with a company in Waterloo and I do get deductions for all my vehicles as well as deductions for my our home and boat. With respect to the home, it helps to have a Bulgar alarm system  as well as 24 hr external video, ( we are not in a high crime area...I just like technology) and in close proximity to a fire hydrant..(weird, but true...don't fire trucks carry long hoses)

I have only made one "home" claim in my life and that was for the diamond that must have come out of my wife's engagement ring while diving about 5 years ago. I have never made a claim for any vehicle...boat excepted...the Admiral did hit a rock  when the boat was new... 17 years ago.

Health Insurance ?? In our case it is not required, even when we travel. Our continuing medical Insurance covers each us up to 1 Million when out of country. Fortunately the only insurance we have to buy is TRIP CANCELLATION should we leave the country. I am sure you are well versed in the multitude of insurance companies now advocating "extra" coverage besides what our National/Provincial plans cover. We are fortunate that we do not need such a policy.

We do agree, "Pay for Play" certainly is the answer for many problems that face communities but the gouging by the Liberals in Ontario is beyond the boundaries of fiscal responsibility and now Carbon Tax...which in my mind is a joke/cash grab.....

You may recall that many stores phased out plastic bags and now charge $0.10 per bag.......where did that $0.10 go.....It went, according to all the stores when queried by the media, into a fund to improve recycling. Being retired and having lots of "spare" time in the winter I started asking grocery  stores where and how they account for the revenue for selling plastic bags. The managers I talked to in 7 stores, in our area and the surrounding areas, stated that they "did not know" if there was a separate account for keeping the revenue from selling bags and most, when pressed admitted that it probably went into general revenue.....what happened to the "for all - the greater good" ?

But I have digressed....  the health system in Canada......My opinion is that it is getting very very close to being "broken". It is overburdened and underfunded, and part of the reason is that folks are living longer than when the system was put in place. The other problem could be the abuse of the system by many, and that is not to say " just immigrants". Many people can't find their own doctor so end up in Emerg for the slightest ailment thus wait times get longer and longer.

If people can't find a family doctor there has to be a reason........and in the vast majority of cases I would say doctors leave because of low pay in Canada......perhaps it follows that  Doctors do make more elsewhere. Well how much should a man/woman that can save lives be paid...?? Well when you see CEO's sitting in their penthouse suites with a dozen minions at their beck and call while they themselves are  pulling in millions of dollars for basically being a figure-head it makes you wonder.

Again, my opinion.....new arrivals  should  get some time in and then enjoy the perqs of being a Canadian, but don't step off the boat with your entire family and soon  start flooding the system just because it's there. Basically immigrants and refugees should Pay to Play, (tax dollars), for a set period of time. Stating that as a requirement certainly isn't going to deter those that want to live in the Great White North from landing on our shores and airports.

Have a nice weekend.

DKP

[DEFCON]

85% of the health care dollars expended on the medical support one Ontarian occurs during the final five years of the individuals life.

If the majority of the young are generally healthy and paying for insurance to cover the risk of the present day only and retirees are mostly on fixed incomes and paying little in taxes, but regular users of the system, who's covering the nut for their final five expensive years?

Everything health care begins and ends with money, but that issue isn't limiting the timely and safe delivery of health care services across this Country, it's a very serious lack of resources.

As I've said before; when politicians decided to add 300000 third world refugees to the health care mix without first ensuring the proper medical resources were in place, which includes another 6000 physicians, 10000 nurses, 20000 technicians & support staff as well as the necessary facilities, equipment & supplies, people like Kip and family are being triaged to the back of the line as a matter of necessity.

No one can say this is a new problem either; it's been growing in size & scope for the past thirty years.

Geriatrics were and to a degree remain a significant part of the problem. A friend was Chief of a large city hospital emergency department back in the nineties. 80% of the traffic passing through the unit were geriatrics that lived alone and were starved for attention. Older people are not concerned about costs and the like and know that a quick 911 call with a complaint of chest pain is enough to make them the center of attention for a period of time and provides relief from boredom. 

 

     

 

 

[DEFCON]

Kip brought up plastic grocery bags. I don't know what the final cost per bag to the grocer is, but at .10 a bag, you can be sure the margins on said bag are amongst the highest of any product offered for sale in store.

 

[Guest]

15 hours ago, bluemic said:

I don't normally get into these types of discussions mostly because, like so many other topics, there is really no 'correct' solution.  One discovers these little truths the older one gets I'm finding.

But Kip, how would you address the hypothetical issue of say, a recent immigrant finding him/herself the victim of a vicious assault?  Or being diagnosed with a serious disease?  Does a family member have to show up at emerg with a recent T4 slip in order to commence treatment?  And failing being able to produce said T4, does the hospital say, "Sorry"?  Followed by, "Next!"

Nothing is ever black and white'...

Then  we must also consider the new immigrant (Canadian Citizen) from another Province who also has never paid taxes to their new Province of Residence.  Maybe be a reduced level of coverage based on the % of Federal Funding (they did of course pay into the Feds) that the Province received from the Feds until such time as the % difference is paid by the new resident?

Quote

Spending on healthcare varies across Canada, but on average provinces spend approximately 40% of their total budgets on healthcare (Canadian Institute for Health Information, 2013). Per capita spending in 2013 for all of Canada is projected to be $5,988, but spending by province ranges from $5,775 in BC to a high $7,132 in Newfoundland and Labrador (Canadian Institute for Health Information, 2013).

 And then of course there is the much larger group of people in every Province who don't pay any taxes etc but do qualify for Medical coverage.  Kip: it would indeed be a slippery slope.  

That being said, a comment re Emergency rooms. Based on over a 1000 hours volunteering in an emergency department, I noticed that the majority of those (non critical) who turn up are not lacking access to a MD but rather are going to the ED rather than waiting for an appointment with their MD or not willing to go to our many walk in clinics but instead go to the ED with an expectation of being served fast. This of course results in packed ED's and often after a wait of 2 to 3 hours, the non ED patients suddenly recover and leave while complaining about the "poor" service. In an attempt to educate those folks the following web site was set up to inform them of their choices etc. http://www.albertahealthservices.ca/options/Page11972.aspx

[Boney]

We pay a high rate of taxes. It is suppose to run the country. Things like health care, maintanance of our roads and highways, electricity, water, and other necessities for living in this beautiful country. 

However, I'm against user fees for medical care, tolls, etc, as our taxes are suppose to cover these items.

Our government uses our taxes to fund other pet projects, thus not doing what needs to be done. 

This is my beef with the federal, provincial and local government officials.

I make it my business to vote to keep them honest. It's our right that keeps us "free". 

Cheers. 

[Guest]

Boney: I quite agree.  I wonder how much $$$$ would we save if we made every level of Government who take off away from their paid quarters to have a "Retreat" stay home or pay for the costs (no taxpayer money to be used)?

[Airband]

12 hours ago, DEFCON said:

As I've said before; when politicians decided to add 300000 third world refugees to the health care mix without first ensuring the proper medical resources were in place, which includes another 6000 physicians, 10000 nurses, 20000 technicians & support staff as well as the necessary facilities, equipment & supplies, people like Kip and family are being triaged to the back of the line as a matter of necessity.

Be interesting to know how you arrived at the 6000 physician requirement. That figure would indicate a physician/immigrant population ratio of 20 per 1000. Latest  Canadian Medical Association stats indicate a physician/population ratio 2.4 per 1000 in Canada. A view of any supporting documentation lending credence to the conclusion that the first year immigrant population requires a ratio of physicians to attend to it some 8 times the Canadian average would certainly be helpful in understanding your position. Might any be available?

[DEFCON]

Thanks for the great question Airband.

The statistics you've posted don't represent the 'ideal', just the reality. To satisfy our Country's normal daily medical demands, a ratio of something close to 3.5 physicians per 1000 people would be in order. We also can't forget that physicians require all the supporting infrastructure listed above to practice as well.

The medical issues of third world populations are varied, complex and extensive. If a first world country is going to admit third world refugee populations in huge waves, the migrants each need to be screened & properly treated to avoid the introduction of exotic disease processes into resident host populations and that's where Canada's noble gesture becomes potentially dangerous to its population.

My answer is purposely short and not intended to serve as a comprehensive list of considerations that should be addressed medically when very large refugee populations are suddenly introduced into first world societies. 

 

 

 

 

 

 

[DEFCON]

Malcolm described another system problem, people attending ER's for trivial problems.

When those people finally leave the facility complaining of long waits for service, that tells us the 'triage' system is doing its job.

On the other hand, when a victim of a heart attack is housed in the hallway of an ER unit for twentyfour + hours awaiting transfer to another facility that offers cardiac care, not an unusual occurrence, the delay cannot be medically justified.

 

[UpperDeck]

Just a question....how many here actually know anything about how a physician is paid for services in Ontario? I suspect few. And how many maintaining a practice are available more then 200 days a year?

And how many know the percentage of patients attending at a physician's office more than twice a year who are on some form of "income assistance"?

I can get an MRI tomorrow in the US for $150.

Know how long it would take to get one in Ontario for "diffuse knee pain" ?

Folks...it's worse than you think UNLESS you are in dire need of critical emergent care and then....we're good.

[DEFCON]

Kip actually raised several important issues related to government stewardship; CPP was one of them.

Health care is going the way of the CPP.

In the case of CPP, the Government collected money from the worker and employer promising to hold and invest it until the day the employee retired at which time he would receive a benefit that was defined by the combined amount of the two contributions etc. to a maximum value ... the government was not a contributor.

As Kip has indicated, the Government is now stealing back the retirees investment in his future financial well being, the one the government made mandatory.

I am aware that people are living longer and of all the other guises politicians employ to explain away the loss of the plan's integrity and subsequent draconian clawbacks.

As unlikely as it is, I would like to see an honest accounting that delivers the true facts of the CPP situation to the people that were forced to pay into the plan, but are now being denied the benefit.

Health care represents a similar dilemma. Government keeps adding people to the benefit list that have not and aren't ever likely to become net contributors. Legitimate 'emergency health care' as described by Bluemic above is one thing, but to make a tax paying Canadian stand in line behind any one of the thousands of hyphenated residents that make Canada their health care & other benefit destination when required, but spend the rest of the time 'vacationing' back 'at their true home'. This is anything but a small problem.

 

 

[Guest]

Interesting numbers re the cost of bringing in refugees, however in this case I have no problem with the $$$$.  I do wonder how we can / will accommodate this group and introduce them to "Canadian ways and values" and in particular treat any physiologic harm caused by their treatment . Are we set up to provide these services and if no what is our government doing to quickly establish them?  If you are interesting in this little known (at least here in Canada) are, here is a link to some information: https://www.theguardian.com/world/2014/aug/07/who-yazidi-isis-iraq-religion-ethnicity-mountains

Canada to spend $28 million to give asylum to 1,200 more Yazidi refugees fleeing ISIL

 

‎Yesterday, ‎February ‎21, ‎2017, ‏‎4:49:50 PM | Terry Pedwell, The Canadian Press

OTTAWA — Some 1,200 people considered to be among the most vulnerable refugees in the world are to be housed in Canada by the end of this year, the Trudeau government announced Tuesday — a move praised by Conservative MP Michelle Rempel as a message to the world that the persecuted Yazidi population needs to be a greater priority for safe-haven countries.

Nearly 400 Yazidi refugees and other survivors of Islamist extremists have already been accepted over the last four months, Immigration Minister Ahmed Hussen said in announcing the initiative, which is expected to cost $28 million.

But unlike the thousands of refugees fleeing violence in Syria who were greeted by flashing cameras and intense public exposure, the Yazidis have been entering the country with no fanfare. That won’t change, say government officials who are protecting the identity of the asylum seekers because of just how vulnerable they are.

“Some of these women haven’t even told their own families about what they experienced” at the hands of their persecutors, associate deputy immigration minister Dawn Edlund told a news conference alongside Hussen.

Others are worried that, should their identities be revealed, the family members and friends they’ve left behind will face retribution, she said.

Hussen wouldn’t detail the experiences the Yazidis have endured, encouraging reporters to instead seek out the information from United Nations reports that have chronicled their fate at the hands of extremists bent on genocide.

But Rempel, who commended the Liberals for taking in the Yazidis after her own previous Conservative government failed to act, said she’s been shocked by the stories she’s heard and amazed by the resilience of the survivors of rape, torture and other unspeakable atrocities.

“The reality is that if the international community doesn’t wake up to the plight of these people, they will be wiped off the face of the earth,” Rempel said.

“And that’s why it’s so important to look at resettlement of these people as only one very small piece of the broader puzzle.”

In addition to 1,200 government-assisted refugees, the government says it also intends to facilitate private sponsorships of Yazidi refugees.

The announcement came four months after the House of Commons unanimously supported a Conservative motion that called on the government to provide asylum to an unspecified number of Yazidi women and girls.

The motion recognized that the Islamic State of Iraq and the Levant is committing genocide against the Yazidi people and holding many of the religious group’s women and girls as sex slaves.

Although the motion referred only to providing asylum to Yazidi women and girls, the 1,200 refugees will include male family members.

Immigration Minister Ahmed Hussen said the government has learned that ISIL also deliberately targets young boys and, therefore, “helping to resettle all child survivors is vital to this work.”

The minister also contended that keeping families together will help the refugees adjust to living in Canada and heal from the trauma they’ve suffered.

Although the motion referred strictly to the Yazidi people, the government is not confining its efforts solely to members of that religious group, who live primarily in northern Iraq.

Hussen said Canada has long offered protection to refugees based on “vulnerability, not religion or ethnicity” and will thus focus on “highly vulnerable” survivors of ISIL. Still, he said a “significant majority” of the 1,200 will be Yazidi due to the “high level of violence” they’ve suffered.

The Yazidi people are “an integral part” of Iraq’s society and it’s important to preserve that, Hussen argued, adding that’s why the government is focusing on “a small number of people for whom resettlement is the best option.”

Moreover, Hussen said the government is taking lessons from Germany — which resettled just more than 1,000 ISIL survivors from northern Iraq over the course of a year — on how to work safely in a volatile environment to identify and run security checks on refugees and how best to ensure that the necessary settlement services are in place once they arrive in Canada.

“As many have experienced unimaginable trauma, both physical and emotional, many will have unique psychological and social needs such as trauma counselling,” Hussen said.

While the majority of the 1,200 refugees will come from Iraq, the government said some will also be accepted from Lebanon and Turkey.