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The Doctor Will See Your Credit Score Now
mytrip writes to mention that the same people who invented credit scores are working to create a similar system for hospitals and other health care providers. "The project, dubbed "MedFICO" in some early press reports, will aid hospitals in assessing a patient's ability to pay their medical bills. But privacy advocates are worried that the notorious errors that have caused frequent criticism of the credit system will also cause trouble with any attempt to create a health-related risk score. They also fear that a low score might impact the quality of the health care that patients receive."
They also fear that a low score might impact the quality of the health care that patients receive.
Of course this will impact the quality of healthcare that people receive. Don't be absurd. Look, as someone who is involved in his family business (12 docs, 100 total employees), the ability of patients to pay is fundamental because healthcare is a business. Doctors graduate medical school with six figures in debt, buildings cost money, running a business with good people takes money to pay your employees with and more. It is hard enough as a small business in medicine, but competing with larger hospital groups who make access like this part of their business practice (like HMOs) are making it even harder because they shunt patients who are less able to pay to the local doctors or smaller clinics, and these are the businesses that suffer the burden of non-payment.
What is the solution? Trying to figure out who has what insurance (some insurance is better than other types) and who can afford to pay for more expensive procedures is just bad medicine and bad social responsibility. Socialized medicine is not it either, however, a return to fee for service medicine is a better option for all people involved. Scrap the HMOs (who are in business to make money, not provide health care), scrap the insurance companies (middle men extracting their pound of flesh) and return to a system where you pay for services rendered with insurance for catastrophic coverage. Granted, many specialized procedures will not be utilized as much but health care coverage for two healthy people is often in the $8k-$12k/year range as it is. And what is the average American getting for that expenditure? You are paying typically out of pocket expenses on top of that as well if you do take advantage of health care services and if you prove a bad insurance risk, you get dropped entirely. Look, insurance companies are not in business to help you stay healthy, or get well... They are publicly traded companies who's bottom line is profit and that profit comes at your expense. A classic parasitic business model that has been promulgated on the American public. However, this will have to change as it is dragging down US business, small and large, big time.
how about having a MDFICO (quality of provider)? hell! they wouldn't like that a bit, would they?
Because I know the types of posts that are coming.
There's no such thing as a free lunch.
It will never happen. Corporate America can do what it likes to individual Americans, who can't do a damned thing about it as a rule.
Those are my principles, and if you don't like them... well, I have others.
I'm kinda liking the idea of scores based on how likely all insurance companies (auto, medical, etc.) are to pay.
"The use-mention distinction" is not "enforced here."
I would agree to having my ability to pay shown to a doctor if a doctor is able to provide me a score of his/her ability to heal. In my experience a lot of doctors are tired, overworked, ignorant, and generally burnt out. I've been burnt out so I do not blame them personally but it would be nice if doctors had to prove them selves by showing people their resume, portfolio of patients, and some references; kind of like other professions that actually has to compete to get work.
In the United States, those in middle-to-low income groups often get very poor health insurance from their employer, or worse, depend on Medicare/aid grants from the government.
This means that only those with money have proper access to health care, treatment and diagnosis.
In Australia, private cover is only designed to be an add-on for existing government-provided cover via the Pharmaceutical benefits scheme and Medicare. Medicare levies are paid on an income-ramped scale, and you can be exempt in some cases from paying altogether.
In this way, those that can afford good health care (i.e high incomes) enable those who cannot (low incomes) with at least a baseline medical cover that is far more extensive than the government health grants in the US of A.
This introduction of a credit-rating style scheme only makes the problem worse. Someone may have been unemployed and become very ill, and ended up being unable to pay medical bills promptly/at all. They may later have become employed - perhaps even at a high income, but will therefore still be cursed with a poor medical credit rating and be turned away from healthcare.
No one should be denied medical treatment in this way, and the fact that this system is being developed suggests there is something wrong with excessively privatized health like in the United States.
Like I said before... baby boomer DINKs getting medicare before your parents. That's what this stuff is about, preparing for the coming wave of no longer able bodied and making sure that the number of those monopoly bucks the Fed prints are still what gets you into line.
-1 Uncomfortable Truth
We also need real accountability for credit reporting agencies. Simply requiring them to change incorrect information after the damage is already for done and requiring each of us to police the companies on our own dime - is crazy. They're immune for normal charges of libel, and should not be.
Not my credit score.
In my local paper, there was an opinion article about this that pointed out that credit scores reflect (for the most part) voluntary debt, while medical debt is involuntary debt.
Most people can decide to buy a more expensive car than a less expensive car, or put a new TV on a credit card. But breaking a bone isn't a voluntary decision.
This is a good thing. We need more free market forces at work in medicine. The entire civilized world seems to have fallen into this belief that its normal for health care to cost vast sums of money even for relatively simple and routine things. We wouldnt have this problem of people not being able to pay for most health care related services to begin with if it werent for the fact that we have removed the efficiencies that should exist in a market based economy. If we simply did away with all of the things that cause prices to be artificially inflated like insurance (whether government or private) people would be far better off in the long run.
Reminding me of this episode:
http://en.wikipedia.org/wiki/Critical_Care_(Star_Trek:_Voyager)
I forgot what it was called, the something "quotient" which was determined by a computer.
Given the rhetoric of some politicians you'd think the health care industry would be trying as hard as it could to encourage people to support the existing system. Instead they seem bent on driving everyone to embrace socialized health care.
Receptionist: Do you have a Q4A5 planet insurance waiver?
Xev: No.
Receptionist: A D-class standard waiver?
Xev: Sorry.
Receptionist: Any waivers of any kind?
Xev: No.
Receptionist: Then cash will be fine.
Xev: Pardon?
Receptionist: Precious metals or bankable equivalents.
Xev: We have no precious metals or bankable anything.
Receptionist: Then your situation becomes a class 1313.
Xev: What's that?
Receptionist: Ignored.
Xev: You can't do that.
Receptionist: I'm afraid I have no choice. Policy is policy.
Kai: We will pay you later.
Receptionist: I'm sorry, MEDSAT does not accept credit.
Xev: This is an emergency!
Receptionist: I understand. Please inform the next person to appear on the screen.
Xev: Hey, lady, watch! Lexx, blow up that little red moon we just passed.
Nice system ya got there. Up here in Canada, we're not quite that far gone (yet).
There is nothing stopping an enterprising consumer from setting up a DocFICO. Bascially a MedFICO in reverse, where the consumers would rate the doctors on their skills and possibly number of malpractice suits filed against them. Perhaps, something like this is needed to even the playing field.
But lets not forget that Medicine, like any other business, is a business, and the way that businesses stay afloat is by providing a service (or product) that paying customers will want. That being the case, someone found that there was a business need for doctors to rate their potential patients ability to pay. In the end, from a purely business perspective, this is not much different than Credit Card companies rating their customers ability to repay their loans. Perhaps, this is morally not the ideal path for us to be taking...
Comment removed based on user account deletion
Next step will be healthFICO score that will determine your eligibility for insurance and your insurance cost, based on your past illnesses reported to Equifax
Let's put up a web site where you can post the hospital's medical score.
We can see how many sponges got left in patients, etc. Just sounds fair to me.
-- Programming with boost is like building a house with lego. It's a cool but I wouldn't want to live in it
Speaking as a Canadian I am incredibly grateful to live here. Two years ago I had an emergency appendectomy, overnight in ER, CAT scan, emergency surgery followed by a couple days of recovery. How much did this cost me out of pocket? Not a penny. You see we have socialized health care here, if you're sick you get taken care of and you don't have to worry about being bankrupt by the bill.
Add to this more doctors per capita than in the US, more hospital beds per capita, and a longer lifespan and I can't possibly see what sane or rational arguments Americans can make that socialized health care is worse than a pseudo-free market system like in the US.
I didn't realize that health coverage was affordable in the first place that a person could actually pay for it. That's why my health coverage is a monthly membership to the local gym for the last six years.
Trying to figure out who has what insurance (some insurance is better than other types) and who can afford to pay for more expensive procedures is just bad medicine and bad social responsibility.
Real-world data shows this to be false. Countries that emphasize prevention, regular check-ups, and healthy lifestyles have better health outcomes at much lower cost than the US. Those are the kinds of medical services that people should be given without regard to their ability to pay.
But if you choose to live an unhealthy lifestyle and then need three heart bypasses and a kidney transplant, you should pay for those yourself or accept the consequences of your irresponsibility.
Health care costs are spiraling out of control because medicine sells the illusion that they can fix anything if only paid enough, and people believe those lies and live accordingly.
It would also be interesting to have scoring of the FICO scoring.
Right.
I had to remind the Doc at the last appt I just had that twice an 18 mg dose is 36 mg, not 40.
I have had the worst trouble with any entity that I ever owed money to with doctor's offices. Thanks to the time it can take to go through all the insurance paperwork, it can be MONTHS before a debt is finally billed to you so that you can clear it. This only gets worse when you consider the massively outsourced structure of medicine today. I've had miscellaneous expenses from various outsourced diagnostic clinics that tests were sent off take over 8 months to reach me after a visit, and I've had to deal with phantom late charges generated two months after bills were completely paid off!
The last thing I want is a credit system determining how important of a patient I am based on the ineptitude of other doctors at billing me correctly.
If it's for-profit but free, you're not the customer -- you're the product (e.g., the Slashdot Beta's "audience").
from putting every aspect of our lives to an index. We won't be able to get good service at a restaurant because our ACTT (Average Cost to Tip) Index is too low and the waitress is busy working the patrons with above average scores. Frugal shoppers will be stuck in long lines in the grocery store because the index that keeps track of how many high markup, name brand products we buy won't qualify us for the express lanes for prefered customers. Our MedFICO score will be shot because the new wave of Medical History Theft screwed us up before privacy and consumer laws could catch up to the problems and we'll have to goto Mexico for our routine exams.
Unfortunately the people making these indexes never have to tell single mothers with starving children that they can't use their services. They give that job to the other single mothers with starving children that they've hired minimum wage to work the reception desk. If they did, they might realize that people are actually more than the sum of their indexes.
If you had to choose between paying for basic needs for yourself and family and paying big bills on time to maintain a perfect credit score, which one would you choose? This is a tough decision that many people have to reconcile. The practice of employers using credit scores to determine if an applicant gets hired for a position can obviously be seen as a social engineering tool. Just in this practice alone, there are ethical issues that rise to the surface. How can a credit score determine the true character of a person? A credit score cannot give account of the money lessons that a person has learned. A credit score cannot testify to the vision and long-range goals that a person has. A credit score alone cannot give accurate and realistic insight into a person's sense of judgment when it comes to prioritizing needs versus wants. Is this to say that bad credit happens to good people? The answer is yes, especially when a person that was not taught financial literacy [typical of public schools] finds himself unemployed or under-employed.
To base the quality of health care that one receives on a person's credit rating is downright unethical. It amounts to putting money (a replaceable item) ahead of life (an irreplaceable thing). A credit score is an algorithmically derived number that cannot predict if an individual would eventually become successful or productive years later. Just imagine a person that would have made a worthy contribution to mankind except for one thing: that person died years before because of a poor credit score!
nuf sed
Table-ized A.I.
The big problem with the sub prime situation was that these loans were made with the intent of selling them off to investments that wouldn't need the going rate of return. The customer in default wouldn't be the customer of the broker who wrote the loan. The idea is, get the loan for a set amount of time at a lower rate, then mark it up based on the going rate a few years down the road and hopefully the homeowner could afford the increased rates.
The lending companies couldn't barrow money as cheap as the loans were going out so the idea was to sell them off for a fraction of the paid value so they could keep making loans. This constant cycling of loans would have inflated their values too. But when the brokers realized that these loans wouldn't come back on them, they started making them to higher risk people because they could grab a commission and not have to worry about losing their jobs when it comes back. The government was behind all this except the brokers making the loans to risky people. It is just another thing they neglected until it became a problem.
It is sort of what lead to the land grabs of the 70's where the banking regulations were relaxed to help them make money and stimulate the econemy. Instead of having the effect of a small revenue generation while letting them invest a little into real estate, it ended up with them driving the prices way up which allowed farmers to take $2500 an acre loans out to buy combines on land that was valued at less then $100 per acre a few years before. This of course jacked the prices up so high that no one was buying which means a lot of the banks defaulted on their own mortgages leading into the savings and loan crisis and all the family farms loosing their property.
These two situation alone should be proof that we don't want the government mucking around with this stuff. Add on to this the fact that almost everything we dislike or think is a problem with modern health care is a direct result in them attempting to fix health care with the HMO act in the 70's. There is no reason for any sane person to want them involved at all. They either ignore some important part, or sit back blindly while people find ways to legally exploit the system.
It turns out the triumph of the value of money over human life in the United States is now complete.
When it comes to any kind of non-trivial medical care, you don't have any choice and have to accept whatever is offered. Without choice, the market is not free. Therefore it is simply impossible to base a health care industry on capitalism. Socialised health care is the only workable option (and yes, it does work in many advanced, western countries despite what the American propaganda says). If you don't believe that socialised health care is the best way, then I suggest that you go do some research beyond TV.
MOD PARENT UP. There is no other profession (other than priests maybe) that protect their own from real accountability when they screw up.
As a poor person / family that lives in a HMO based state, getting medical care sucks. I recently had to drive 30 miles just to get a eye exam. THEN, getting the glasses was locally in town. WTF? Prior to the HMO crap everything was in town. My wife might have cancer, and to add insult to that, we had to wait for "permission" from the HMO to have the fucking tests done. ?? (which took 2 months) It's not medical assistance, it's medical resistance!
Life was hell, then I discovered Linux...
- As a financial instrument, insurance exists to distribute risk, not cost. Anybody who does not understand what the distinction is please vacate the discussion. Technically speaking, insurance is how one distributes risk and some approximation of communist government (in a literal rather than pejorative sense) is how one distributes cost. Trying to use the former to approximate the latter is inefficient and raises the costs for everyone.
- For all the inefficiency and expense of what passes for health care in the US, the US also has the best health care outcomes in the industrialized world and generally by a wide margin. If you have cancer, your survival rates in the US are much better than Europe on average and the best in the world in absolute terms. This is true by a number of other direct metrics of health outcomes and holds across the population even if you are an average person and not a wealthy person. Americans are paying more but they are getting more, and survival rates for a pretty broad swath of nasty things is 20-40% better, not buried in the noise floor. This is the good part of the US health care system that no socialized system has ever emulated. Americans compensate for being unhealthy (and car accidents, etc) in mortality rates with really good medical outcomes. If you normalize for genetics and environment, Americans live longer than anyone else. Of course, many Americans have crap genetics and have a crap diet as far as longevity is concerned.
- Before the Americans get too smug, the American health care "system" (there is no system, it is a market) is byzantine and inefficient. It should cost nowhere near what it does even for what Americans get.
- All Americans have health care, even those that cannot afford it, and the idea that there are people without access to health care is a myth that inflames the clueless and serves the purposes of political propaganda. The quality is mediocre, but what do you expect with socialized medicine. It is not hypothetical, I was one of those invisible souls raised on government health care for the destitute.
What we really have is a number of facts. The European system produces mediocre results in terms of actual health care outcomes (what we are nominally paying for), but it is relatively inexpensive. Americans pay a lot but have the best health care outcomes in the world. Americans pay far more than is strictly necessary by any reasonable metric, but I guess they can afford it. Americans are also bearing the cost of most medical technology innovation, amortized in the American medical market; when is the rest of the industrialized world going to carry their fair share of that burden?
In short, all the systems suck. That said, I would be reluctant to give up the superior health outcomes (what I pay doctors for) and medical innovation of the American medical environment. On the other hand, I wish they were more efficient at what they do. Clearly there has to be a better way, but by every metric that matters to someone getting health care, replicating the European system is not it.
It turns out the triumph of the value of money over human life in the United States is now complete.
Medical One: "What's in your spleen?"
Table-ized A.I.
I found this article about insurance rates for doctors in the us, a few choice quotes:
Jury Verdict Research, of Horsham, Pa., reports that nearly half of all awards in medical malpractice cases topped $1 million in 1999, the most recent period for which data are complete. Simply settling a claim cost an insurer $650,000, up 30 percent in a single year.
West Virginia obstetricians paid an average of $75,155 in 2001, while their colleagues next door in Kentucky were charged only $41,661.
Obstetricians, neurosurgeons, emergency physicians and other high-risk specialists have absorbed the brunt of the blow. It can cost an ob-gyn in South Florida $209,000 a year to insure for delivery of babies.
Once again, American libertarian Slashdotters come out in droves to let us know that socialized medicine couldn't possibly work. I guess this is plausible enough, as long as you're suffering from some sort of epistemological disorder that prevents you from perceiving the universe outside the borders of the United States. Because in every other Western industrialized nation, some sort of socialized medicine has been the reality for decades, and, not coincidentally, they all provide a better standard of care to their citizens for less money than we do here in the USA. (Yes, even with the waiting lists.)
Argue, if you want, that health care shouldn't be universal on some sort of social Darwinist grounds ("The sick should die, because they are weak!"), but please stop trying to suggest that there's something inherently unworkable about government-provided health care. It's sort of like arguing that the Earth is flat or that water runs uphill: it's clearly contradicted by fact.
No, Ron Paul is running a little late.
Table-ized A.I.
for humans having any humanity. Call Putin, launch the nukes, go out right and give some other species a chance. I know they could do worse or better. We just seem to get worse.
Many hospitals will try to bill in triple if possible. My boss has been billed in triple several times, and each time he has called the hospital, asked them for prices on their procedures, and stated he would only pay the noted price. Even after that, the hospitals would submit the triple billing to his insurance company in hopes they would pay the difference. The problem with the hospital system in the US is the greed on many levels, whether it be from the malpractice lawyers right up to the doctors that will sometimes give unnecessary procedures in order to get more money. The US is one of the only, if not the only, countries in western civilized society that treats medical care like car repair. This sounds like a bit of a drum-circle bongo argument, but to treat health care like a commodity instead of a basic human right in the western civilized world is morally wrong.
Could someone please point out the benefit to the patient when the doctor can assess the patient's ability to pay his medical bills before administering treatment?
It is dangerous to be right when the government is wrong.
Instead... (and it's just an idea) create a system for ranking doctors based on their overall effectiveness of treatment. Yes, it's a subjective criterion. But so is "will this guy pay". I am sure this type of service would have been invented long ago (by oh, say... Consumer Report) if providing it didn't carry a huge risk of litigation. So how about making rating agencies immune from litigation and letting them compete in who can provide better information on who's a better doctor? But, oh, wait, this will never happen -- it's bad for both lawyers (Democrats) and many doctors (Republicans).
Any guest worker system is indistinguishable from indentured servitude.
Since when has any massively invasive data-profiling service ever been about making the consumer's life better?
If it's for-profit but free, you're not the customer -- you're the product (e.g., the Slashdot Beta's "audience").
In 2004, I was diagnosed with Acute Lymphatic Leukemia. At the time, I was working for a rather well known technology company that had a great benefits package, great insurance, and treated me well -- I was placed on Short Term Disability, then Long term Disability, and Aetna/BCBS paid for most of my Rx and Dr's Trips. 18 months later, in 2005, my cancer was in remission, but, my doctor didn't want me back on the road because of my immune system being in the state that it is.
I've changed employers, since then, because I grew tired of being stuck on LTD, and was 'acquired' by another company last year. Same insurance (Aetna became BCBS), similar benefits.
I go to the Pharmacy to grab my Monthly Maintenance Medication this month, only to find out that my employer removed that coverage from the benefits package. Now, I'm paying $750/month for medicine to keep me alive. No Biggie -- I go in for my monthly labwork, only to discover that my blood draws and hematologic shit isn't covered anymore. Well, now I'm kinda getting worried, because It's going to cost me another 1200 to get my lab work done. (We're at $1950/month just to keep me alive, right now, where it used to be $100 -- $80 for my meds, and $20 for the labwork).
Add on top the trips to the Dentist (I've spent over $6K with my Dentist in the past 2 years recovering from the hell that chemotherapy and Barium treatment does to your teeth), and I'm looking to probably spend $24,000 this _year_ on medical bills alone. While Flex plans help, it's really not that much.
This begs the question -- If I had chosen a different career path, and if I was working as a busboy at a restaurant, would I still be alive today?
I'm not saying that Social Medical coverage is the answer. I'm not saying that I know the answer, but, think about things like this:
My brother has a daughter that has Cystic Fibrosis. My brother barely scrapes by on minimum wage. He literally has $250K worth of medical bills from his daughter alone. He can't afford a house, I bought him the car that he drives, and every penny of his money (and every ounce of his love) goes to making sure that his daughter is alive, safe, and cared for.
Yes, I understand that Doctors work very hard to get where they are. I have two engineering degrees, and I am still paying those off at this point in time. I also understand the costs of finding and keeping good talent and staff. At what point do we say, "Your daughter can't live because you can't pay," or, "you can't live because you can't pay?"
I honestly don't think that anyone has a good answer for any of this.
You going to pay for it? Of course they wouldn't like it, but there's no one with enough bucks to pay for getting the quacks rated. Probably the insurance companies do some rating, based on malpractice payouts. But the docs and the hospitals don't want the information to be any more public than that.
I had a (now deceased) friend who was an embalmer. When he got pissed at a doctor's failure to correctly diagnose or treat him, he'd say, "You know, I make my living burying your mistakes." This was not well received by the quacks.
BTW, credit rating used to be pretty fair as credit rating. It is rumored that, some years back, the business got "repurposed" by marketing types who pandered to credit card whores who were less interested in your ability to repay your debt than in how much debt they could persuade you to shoulder, up to, but just short of, bankruptcy.
For the past two years, even this is unnecessary, since they got^Wbought a law passed making credit card debt non-dischargeable in a bankruptcy proceeding. They whined that yuppies were maxing out credit cards, then filing for bankruptcy. They also contended that only a few percent of their losses were due to people paying medical bills. In fact, people tended to want their doctors and hospitals paid for saving their lives, without a lot of delay. Consequently they often transferred their medical bills to their CCs. In the end, it's honestly estimated that well over 50% of credit card debt that results in bankruptcy originated in medical bills.
But the CC bastards, by buying enough legislatorfucks, have now guaranted that the "second chance" which bankruptcy was originally intended to provide is now no more than a dream for most who are forced into it.
Government Hellcare with the efficiency of the post office, the compassion of the IRS and enforced by the bATFeh.
I'd go on a Vegan diet but the delivery time from Vega is too long. --brownkitty
Socialized medicine is bullshit , i should know as i live in Romania , an ex-communist piece of wasteland. Trust me , all you do is pay for the mandatory healthcare insurance and get nothing back. The hospitals look like shit , smell like shit and if you're "lucky" you might just step in shit. Nobody has done any work on them for almost 20 years. I once broke my leg , the ambulance got to me in a mere 3 hours. The equipment is old , so old they usually send you to get tests done at private clinics. If you need an operation , they usually have nothing and you have to go buy everything from cotton pads and rubbing alcohol to the string they sew you up with... so much for insurance. (oh , and the wages and conditions are so low for doctors that you _have_ to bring some sort of bribe or you're not getting anything anytime soon). So have fun! socializing anything does nothing but give power to one organization ...and anything with that much power in one pot is bound to be abused.
Mod parent up. This is what happens when you fall in the middle.
Sadly, it's the case that humans tend to suck massively at risk assessment.
"I'm young, I'm sure as hell not going to pay $500/month for health insurance. I'm too healthy, I couldn't possibly need it!"
Then they get sick, they get in a car wreck, whatever and need a proceedure costing $50,000 - one they can't possibly afford - to maintain quality of life.
Had they put that $500/month aside over ten years, they'd have the money to pay for it. Of course, they haven't. They have had far cooler TVs, they've kept their cars running, maybe got nicer ones.
Instead it's suddenly a terrible crime that non life saving but critical to quality of life medical procedures cost $50,000. It doesn't matter that it costs half a million dollars plus to train each of the four doctors you want to spend hours in surgery. It doesn't matter that hospitals have to charge twice as much because they get sued by people who see it as easy money - and, indeed, if you do cobble that $50,000 together, you'll likely invent some slight to sue over, yourself, so you can get some of it back.
It gets even worse when the moron deciding $500/month is too much is a parent. On say $25k a year, that $6k/year of medical insurance is suddenly a massive chunk of their take home. They rationalize that it's better to invest the money in a nicer home for the kid, a car so they can get to a nicer school, etc., that nothing major will go wrong. Then the kid falls and they discover the life saving option is to simply remove the kids arm as it'll save their life and is far cheaper than the quality of life option that rebuilds it. Now a kid who had no part in their parent's moronic decision making is out an arm, dies of lukemia, whatever... all because the parent sucks at risk assessment.
So, in most things, sure, the government should stay out. When it comes to something their citizens are fundamentally ill equipped to make accurate calls on, then a case gets made that the people who actually crunch the numbers, rather than the ones who go off inaccurate gut feelings, should be the ones making calls... if the consequence is massive destruction of quality of life. Especially if the consequence gets to be massive destruction of someone else's quality of life.
This also goes double when people have made an equally bad call throughout their working careers about putting money aside for retirement. Should they then get a wake up call around retirement age, they've got absolutely no way of ever putting money aside for non-working years to pay those monthly premiums they've now realized are a good idea.
If the purpose of government is to provide those services we're unable or unwilling to provide for ourselves, particularly because we make bad risk assessments on large scale things we don't understand too well (military protection, police, road building, etc.), there's a great case for them if not taking over healthcare, at least making it a legal obligation we're not allowed to think we're smart enough to dodge.
i bet 20 bucks if they system is used lawsuits for male-practice will go up 5 fold cause if they treat someone with bad credit and don't give him/her proper treatment.
"...unless there's a chance they won't pay, in which case, screw 'em."
"A great democracy must be progressive or it will soon cease to be a great democracy." --Theodore Roosevelt
I live in Uruguay, and like the previous Romanian poster, we have a socialized medicine here (a bit mixed, not fully socialized).
,and somehow seem to have better access to healthcare than most of you? (with all the caveats).
It seems to work a bit better than what you're describing (and way better than the Romanian system), but it has some severe downsides.
I get deducted 4,5 % of my salary each month (6% if you have children), and that pays for the monthly fee at the "mutual" (our form of medical care based on the ), which gives me basic health coverage.
By "basie", I mean "call us if you're dying or in severe risk, otherwise don't bother", the hospital seems to have been teleported to Iraq (they started some structural work and didn't have the money to finish it, so the entrance is covered in rubble and you have to enter through a small passageway on the side of the hospital), if you want to be seen by a specialist you have to book it anywhere from a month to three months in advance, unless the doctors (general practitioners?) determine you're likely to die or a severe threat to health from it. Oh, and you pay an extra fee for everything, too.
Medicine is included, but you never get "brand" name stuff, everything is generics, sometimes of dubious quality (I definitely notice a decreased effect from some of the stuff I've taken, in particular I used to suffer from asthma and the generics are nowhere as effective at stopping an attack).
Some medical procedures that seem to be common in the US are not included, dental care besides some tooth extraction is not included (everyone has lousy teeth compared to the US), and god forbid if you have to go to the "emergency" room, it takes something from 1 to 3 hours to be seen by the overworked staff, unless you actually look like you'll die on the spot. Most people (myself included) buy additional emergency services (not included in the social healthcare) which actually come in case of a non life-threatening emergency, and which you can see for all kinds of usual health-related stuff that would take all day in the mutual system (this or that hurts, my son has a fever, etc..).
And even then, only those who work, or whose relatives work, have access to the "mutual system".. the rest goes to the "public" hospitals, which are directly state managed (the "mutual system" seems to be private, non-profit based, see http://en.wikipedia.org/wiki/Mutualism_(economic_theory) ), and those are even worse, even though they do provide basic healthcare.
The upside is, my hospital (with the entrance covered in rubble and all), has access to MRI, CRT and most modern equipment, and instead of being billed into oblivion, if I ever require the use of such services (if the doctors determine that - that is, very less frequently than in the US), I get to use them for a relatively small fee (most expensive procedures are about U$ 50 to U$ 100 fee).
I really can't understand how you can say with a straight face that medical care for someone in the US can be U$ 12.000 per year, even taking into account the huge difference in salaries between here and the US. For comparison, I earn about U$ 6.000 per year after taxes
I don't know how socialized medicine would work in the US, but you already have my anecdotal evidence and the Romanian's, so you can see which you would prefer.
There are three kinds of lies: lies, damned lies, and statistics.
I have never understood this phrase "socialized" medicine you Americans use for a tax payer funded health care system. In the US the police forces, fire services etc are funded by tax payers but you do not describe them as "socialized" police forces etc. Public schools are funded by tax payers, do you have a "socialized" education system? Here in the UK we have had tax payer funded National Health Service for over 50 years. The NHS is just considered a public service like refuse collection, fire and police service, state education etc and from my perspective it is bizarre to talk about healthcare like it is a commodity.
"The vast majority of us who want a free market for health insurance do so because we know that in the long run, everyone including the poor will be much better off. Free markets a) promote innovation and better health care and b) drive costs down.
Do you also stand by this argument regarding fire services and police forces protecting your house and neighbourhood? Do you prefer private fire protection to publicly taxed fire departments, and private law enforcement over public police? Just curious as perplexed as it seems to me as an outsider that "socialized" fire and police protection seem acceptable but "socialized medicine" appear to be less acceptable in the USA. Wondering where the difference between these services is seen by the American public?
Wow, someone who gets it. If I still had mod points, one would be yours. This is the biggest fallacy of the free-market boosters when it comes to health care; the primary assumption is false, the market isn't free because the buyer places an essentially infinite value on his own life, and the seller of course takes advantage of that. As a Canadian, what I find interesting is how much less expensive health care is here for those who do have to pay. A couple we know had a baby some time ago, and she is American, with no health care coverage here in Canada at all. In other words, she had to pay for the hospital stay, the delivery, and the doctors to attend at her c-section. Having her baby cost her $3000 here in Canada, total. Having the same services in the US would have cost her $30,000. Now, tell me again that the "free-market", American system is more efficient than our socialized system here. Canada's health care system is by no means the most efficient, probably not even close, but it manages to be more efficient than the American system by a factor of ten, at least for this procedure.
Rule of Slashdot #0: You and people like you are not representative of the larger population. - A.C.
Mine!
The best things in life are free
Mine!
I own the beach and the blazing sunset
Mine!
I own the waves and the fresh air
Mine!
I drink the milk of the stars in this beautiful moment
Say to yourself
ALL THESE THINGS ARE MINE!
Repeat after me!
Money's not our God
Do you grovel to your master?
Do you beg like a dog?
First things first,repeat to yourself
AHHH MONEY!
semantics are everything!
Just turn it around then see if you still agree with your own premise. A new MedFICO score is being developed to assure only the poor receive the best health care. The rich who have jobs and insurance will be excluded from obtaining anything but very basic primary care, if they're able to find it at all.
If I go through your posts I bet I'd find you disagreed with most anything the government or business does that takes something away from you. Have you ever posted against the RIAA? Why? It's all about them getting rich off your back. You support that right? I doubt it.
There is never a purely xxx'ist society that's good for the masses. A capitalist society is evil in of itself. To have a healthy mass living together you need a mix of "ists" and "isms". Capitalism is only one in that mix. Life is about balance. None of the "ists" or "isms" can exist in isolation. Denying the poor health care for the sake of capitalism is going too far.
Again, JMHO -[d]-
There is no free market in America for medical services. The AMA has spent most of its existence eliminating any possible competition. For example,prior to the establishment of the AMA medical cartel, midwifes handled most births and your pharmacist diagnosed minor illnesses. By a long well funded effort, these services were made illegal throughout the U.S. The continuing battle between Optometrists and Ophthalmologists is an example of this. The main result of this is that you have to pay dearly for the services of a much educated expensive physician to get a stitch or two applied to a cut or to get a cold diagnosed. Requiring a prescription for almost all medicines is another form of physician monopoly. Physicians don't want the poor to diagnose and treat themselves, neither do they want to help them.
Hospitals are little better. Procedures and examinations are no longer performed by salaried staff, but are handled by independent contracting medical firms, each with its own staff, overhead and desire for profit. Go wander around any non government American hospital. You will find a medical condo rather than an institution.
Looking at the way medical business works in the U.S., I often think that the purpose is to eliminate availability to potential customers. By shooting for the big fee, the expensive test (too often un-necessary, even people with health insurance are blocked from using their services.
Medicine, American style, is no longer a profession, but just another way to make huge profits at the consumers expense. As a group, physicians have managed to lower themselves to the level of morticians and used car salesmen.
This would give hospitals a bigger bully pulpit to force you to pay whatever they bill. If a dispute takes 3 months that would surely hurt your score, thus giving hospitals leverage to bill high and force payment.
Now, when I show up as a freshly graduated student with no debt history (scholarships) and a $50k a year job, they can go ahead and turn me down for treatment because I "can't pay."
Couldn't get a car loan, and I had a hell of a time getting a credit card to even start building debt.
Credit score says nothing about financial responsibility, just that you're playing their game properly. I still don't see how paying off a $300 limit credit card every month shows more financial responsibility (ie, what your credit score is supposedly showing, that you are a lower risk to a loan institution) than actually managing your money so you don't need credit to begin with.
If this starts happening at the local doctor level, everyone will just goto the ER where they are required by law to assist ( at least if they get any federal funding, not sure about 100% private hospitals ).
This is a real bad idea. Just like giving auto insurance companies your credit report. They should only be concerned about your driving record.
---- Booth was a patriot ----
And I have a terrible idea:
How about if your credit score is low enough, then the government is required to pay your bill with tax money? Does it sound like a bad enough idea now? Credit scores on a consistent basis are inaccurate representations of reality, like IQ tests. Or polygraph tests. So we'd be paying for tons of the wrong people to get care. The same way many who can pay would be denied care.
Doctors are similarly reliable in the current system. It used to be that medical care cost a reasonable amount, but now a normal person can't pay out of pocket to be seen. The medical industry is out of control. The AMA has a monopoly on what is considered Health Care, and the whole goddamn thing is a racket. Inject into that the insurance companies and you have a giant, evil cake (analogies are like a comfortable hat to me). And unfortunately, sometimes you need them. Giving them one more point of leverage to fuck people is sort of a really really bad idea. It sucks that you can't just deal directly with doctors anymore.
What's everyone's credit score here, anyway? Mine is 780, and I have no money. No real way to get money, either. Curious.
(credit scores range from 300 to 850)
Please stop stalking me, bro.
Since when were the rich people rich due to a payroll? You think they work for it?
Typically, someone making $1M a year is not making it through a salary. The exceptions are athletes and movie stars.
120,000 may or may not even be upper class. For a family of four in a urban area, I think not.
much in the same way that putting unpaid medical bills on a person's credit report is not quite ethical.
Lest we forget that medical bills aren't something you go into saying, "I know I can't afford to get healthy, but I'm still doing it!"
A hospital sent me to a collection agency for a $2000 bill on a one night ER visit. I had a stomach virus. I was dehydrated and would have died without IV fluids.
now it's on my credit report.
That is not a bad debt. I don't owe that debt at all. If my name was rodriguez and I didn't speak english, I wouldn't have been charged at all.
They're using their grammar skills there.
We'll have socialized medicine before you can snap your fingers. Once you've got thousands of people getting screwed by the medical system as badly as they're being screwed by the credit system you'll see real change in a heartbeat.
You telling me that the system's going to stay intact with hundreds of thousands of sob stories on the TVs about children and adults being denied treatment because they didn't have the "potential" to pay? Not in a million years. This will just prove to the public that the medical system has no interest in providing health care, they are only about selling products. And they'll dismantle it in a heartbeat.
I do not disagree with most of what the poster has to say here. However, I have another point to cover that he did not.
First, while the original intent of insurance was to distribute risk, it is questionable how effective it has actually been in doing so, as a side effect of my second point:
Insurance, by its very nature, is a broken system. It is (to borrow the words of a certain organization) defective by design.
Think about it. As a "middleman", it is in the best interest of insurance companies (or even non-profit insurers) to charge as much as possible from the customer, and pay out as little as possible to the actual health care provider. That unfortunate reality is inherently and solidly fixed in the structure of what "insurance" is.
As a result, we have increasingly been seeing exactly what anyone knowledgeable about the situation would predict: steadily increasing costs, along with increasing reluctance to pay providers for care... to the point that insurance companies have interfered and even gotten involved in the process of "practicing medicine" in order to reduce their own costs.
I do not claim to have an effective solution (other than, in part, to legislate insurance companies away from interfering in actual medical care), but I feel obligated to point out this real and serious problem to people who for some reason do not seem to have quite gotten it yet.
You may not have been ATTACKED, or your borders invaded, but if you think America has not been protecting your political interests for you while you stay home and grow beets or whatever, then you are much more ignorant than the average slashdotter. And that is saying something.
Can you list for us some places where socialized medicine actually DOES work well? And please don't say Canada. That dead horse has risen and been beaten back to death over and over...
When I saw "The Doctor," I immediately thought of Dr. Who. But, alas, the title is refering to medical doctors, or something....
Slashdot, what has happened to you?
Let's see a comprehensive, responsible, and publicly available rating for doctors! Until then, they can stuff my credit score up their asses and worry about prescribing themselves laxatives.
I am tired of deadbeats abusing the system
The phrase "more better" is acceptable English. suck it grammar Nazis
I don't think that the solution is either the status quo or socialized medicine. I think that the medical system has turned into a big special interest dominated dysfunctional cartel.
1. I think the HMO system should be abolished and hospital chains should issue insurance policies instead. Like you pay your local hospital your insurance premium and you get as much free health care there as you want there. That would fix the incentives because right now the hospitals and the insurance companies aren't in a constant capitalist clusterf**k with the patients caught in the middle.
2. I think the best way to fix the system would be to allow non-doctors, maybe with a 2 year degree, to deal with minor medical issues and prescribe medicines. The abusable medicines that are DEA scheduled should only be prescribed by specially licensed practitioners (background checks, etc) but the rest should be available to these "lesser" doctors.
3. Care to the poor should go through the VA system or another system of specialized hospitals so the burdens to the tax system and so forth are obvious and transparent.
will have control soon.
If they let something like this happen... yikes.
One of those doctors creed things is "will help anyone"
and last time I checked, the poor included anyone. Yes, i'm a socialist democrat, but I also have a good living.
Looking at health care as a business is not only fundamentally morally corrupt, but its also not realistic. For example, people have suggested rating physician quality like the asshats who suggest rating a patient's creditworthiness. Fortunately or unfortunately its actually quite hard to measure quality of care that physicians provide. Say for example you decide that you look at a heart surgeon and determine what percent of his patients survive for at least a year after surgery. Sounds pretty simple, except that the best surgeons often are the only ones willing to take the sickest cases, and so the most technically skilled surgeon who takes the cases that no one else will touch looks worse than the technically marginal guy who only cherry picks the easiest cases. Of course measuring things in complex ways like that are harder to do, so you will only get simple (and meaningless) measures on scoring systems (which already exist.) Moreover, there is no easy way you can measure the important things that make a technically competent clinician into a great doctor: sympathy, listening, and actually giving a shit about your patients.
Which brings me to a pet peeve of mine.... I hate few things worse than referring to my patients as 'customers'. I haven't had customers since I waited tables in med school. In my ER practice (which pays the bills) or in the clinic where I volunteer my time two days a week, I only have patients - not a single customer. And trust me, you don't want to be a customer. Because if that were the case, when I am sworn at, pissed on, or threatened with bodily harm, I would happily to let that piece of business walk right out the door. If all I had was customers, when my 'customer' with alcohol intoxication and a head injury who had already vomited on me and took a swing at me after calling me a fucking faggot decides to bolt out of the ER, I wouldn't wrestle him to the ground to keep him in the ER till we get his head CT.
So no, I won't check your credit score. But I also sit at the back and play with my cell phone when they make me attend 'customer service' talks. I don't care about customer satisfaction. In fact, I am of the belief that if every patient I see is fully satisfied with the care they got, I am probably not setting enough limits. (I'm not House, but I am also not the vicodin and antibiotic fairy.) And while I don't give a rats ass about customer service, I do give a rats ass about practicing medicine well, and about the people who are my patients - even if they do puke on me.
So trust me, don't yearn to be a customer. You wouldn't like it.
Rather than everybody either having very high quality health care or no health care as we do in the US, we need a tier that people can buy that's the standard of Health Canada or the british National Health.
Whether that's paid for directly by citizens or via the gov't it should be the same result.
read
Who Killed HealthCare?: America's $2 Trillion Medical Problem - and the Consumer-Driven Cure (Hardcover) Regina Herzlinger
http://www.amazon.com/Who-Killed-HealthCare-Americas-Consumer-Driven/dp/0071487808/ref=pd_bbs_1?ie=UTF8&s=books&qid=1200766820&sr=1-1
Remember that "socialism" in a capitalist country, is "market socialism".
Think about that when making your hole supositions.
In the end, any billionaire, will always have more credit/market to make him healthier, and yours more ill.
join that to politics, and say goodbye to free of speech. (and many other liberties, aswell as your own health).
BTW, this code already exists.
You, slashdotters are being feed the bait, to "think the system up", and realize and grab the best parts of your brain bits, in benefit of the dragon.
if you don't believe me, ask your fellow thinfoilhat friend.
I would never steel from you, but you do realize you just posted an idea that would make you a millionaire right?
Slashdot, where armchair scientists get shouted down and armchair theologians get modded up.
They can only make it worse.
Let's look at empirical evidence to test this claim:
According to the CIA factbook ( https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html ) the United States ranks 29th in overall life expectancy, ahead of Cyprus and behind Bosnia and Herzegovina. Major countries toppping the list include Japan, Sweden, Switzerland, Australia and France. All these countries have government-sponsored healthcare of some sort with near-universal coverage.
Again from the CIA factbook, infant mortality numbers tell a similar story. The US ranks slightly below South Korea and above Croatia in the rankings. Sweden, Japan, Iceland, France, Finland, and Norway have the lowest rates among major countries.
Other health statistics tell a similar story. Among major industrialized countries, those with comprehensive government health coverage have better population-wide metrics than the USA.
The conclusion I reach is that privatized health care only makes it worse.
Yes, facts do have a well known liberal bias....
If your children ever found out how lame you are, they'd murder you in your sleep
Doctors should starve then?
In other news, identity theft becomes even more profitable and more deadly.
Although the conversation feels like a bait-and-switch, "Consumers can't make a choice in an emergency" is a much more serious market problem than "Consumers are choosing products whose lack would kill them". We'll just pretend that you made the former argument from the outset, and that you hadn't been so rude when I provided a counterexample to the latter argument. Stick with the former argument and you'll get lots more support; it's much easier to argue that the emergency ambulance should be as regulated than the emergency fire engine than it is to argue that life-saving thyroid pills are somehow a fundamentally different purchase than life-saving sustenance.
professor is wrong. OK, you don't want an appeal to authority? You're going to probably at least have to refute the book with more than a bad analogy.
Interestingly enough, my non-for-profit health insurance provider "Kaiser Permanente" actually is willing to have a lower total premium + max out of pocket cost for a high deductible HSA health plan than for the HMO-type co-pay plan. I infer from that that they believe some amount of "consumer choice" will lower their costs beyond the foregone premiums.
Sorry, even world wide, it's much more complicated than socialized health care fixes all - which doesn't mean that I'm even necessarily against socialized health care or more specifically I think "single payer" health insurance has potential place.
This is actually a needed component of any overhaul. Right now the discrepancy of what you pay from provider to provider is because there's no market to price the service. There's no market to price services because there's no real data on outcomes. Until you can measure outcomes for any given provider, you cannot possibly price what they are actually providing, and you'll continue to have collusion in the marketplace where one provider will charge an insurance co $1500 for an MRI and an individual paying cash $300.
How about we wait on this "medical credit rating" until after patients can easily see their potential doctor's performance logs? I want to search directories of doctors who are rated by their patients. See how many malpractice suits are lost or settled. See their personal stats of recovery/cure vs failure, compared to industry averages. Then I want to pick the ones who are charging an amount for their services related to their performance compared to the other doctors competing with them for patients.
It's all about the trust, y'all.
--
make install -not war
And it's not unregulated. The corporations that pay the lobbyists buy out the congressmen, and get laws passed that make them more powerful. They get to ignore the taxes everyone else pays, extract resources and manpower from third-world countries, and get away with almost anything. Because no one wants to know where their food, or anything else, comes from, and everyone wants to go shopping. See The Story of Stuff for more details. Given all that, ask yourself this. If they control the government now, what earthly good will giving the government more power do?
I worked for a year and a half in France. Doctors made house calls for children because 1) they didn't want to spread infections and 2) they didn't need an army of clerks to fight with insurance companies. When I did go to the doctor's office, I just signed in on a sheet of paper. The doctor came out, looked to see if anyone was in need of urgent attention and called the next name on the list. But of course, this cannot possibly be a workable system because it is socialized medicine.
Think global, act loco
I have no health insurance, and the hospital I went when I used to have insurance used to bill me for medical services there. Now I need cash up front, even to get something like a TB test where the public health might be at risk. This change in policy happened right after a few small bills went unpaid in collections to my credit report. Now its cash up front or no service. I'm not looking forward to bleeding to death in an emergency room somewhere after I fail a credit check.
Nice random inflammatory statement with no supporting facts. Medicaid (free insurance to poor people) is available to just about any person who can't pay for regular insurance. County hospital, while making you wait for a while, supply free health care to those who need it. Just about every doctor winds up taking care of patients for free EMTALA regulations make sure that non-paying patients aren't dumped. People who show up in emergency rooms (triage) are always seen.
..........FULL STOP.
The U.S. system is absurd. Start with the fact that the U.S. and New Zealand are the only countries that allow prescription drugs to be advertised and go from there. Special interest groups have taken over the government. Policies are in place to benefit the largest campaign contributors, period. And that would be the biggest multinational companies. Small business and citizens are now serving a big business oligarchy. Naturally the biggest most profitable hospital chains would adopt this first. And naturally they will come up with a way to benefit their business allies. Until we vote for real change in Washington DC and our state capitals, this will continue.
Anyone who hasn't read the great sci-fi book Oryx and Crake, should get the book and get some real insight as to where we are headed: Corporate city-states where profit is the only value:
http://www.amazon.com/Oryx-Crake-Margaret-Atwood/dp/0385503857/ref=ed_oe_h
I am prepared to be called by some an "angry white man"....there I have said it, yes I was born in the USA and have ancestry (at least some going back to 1600's in America, who by thew way did their own "doctoring" which of course is illegal now. That said, I think it is time we all begin to realize how much "load" on our health care system is being placed by 1.) Abuse of the system by people who already have socialized medicine in the US (i.e. Illegals, Welfare, congressmen, Women, and Senators)! 2.) Unregulated medical industry who (in concert with the Drug Industry) both heavily lobbies the government and conspire to keep health costs high. 3.) Medical Schools restricting enrollment to minimal levels to "keep the doctor pool small". This results in less physicians in the system, a lack of choice, and essentially monopoly amongst those in the industry, and frankly lack of innovation in that most medical technology lacks the private sector by decades in terms of "high tech" equipment and procedures. 4.) A Food and Drug Administration (who like congress and senate) accept great "kick backs" from large corporations and again conspire to stifle innovation. 5.) Willing accomplices in the American people by not making the effort to contact their legislators and stop this mess. 6.) And finally, of the limited seats in medical institutions int he USA, we need to stop the practice of allowing all comers from foreign countries from entering the USA and getting a medical degree. One should need to be a US citizen in good standing before entering the University. 7.) Eliminating "ambulance chasing lawyers" and malpractice layers from benefiting from the suffering of others. I am not for necessarily limiting the damages in a medical case to patients, I am for setting strong and reasonable limits on what the attorney gets to make from case. Ten percent is enough for God, perhaps an attorney should get 3-5% of actual damages....not punitive. 8.) Enforce the existing immigration laws and this problem virtually goes away (except of course for the pool of illegal Democrat voters that our policies foster). 9.) Insurance companies which act as intermediaries on the delegation of health care. these bureaucrats are not doctors, but in many cases make the decisions which affect quality of life for patients. 10.) Return to locally owned and operated hospitals who have doctors who are from the area and want to help people. the mega mart approach to health care has resulted in much more than increased cost for the patient (and others insured among the same programs). The quality of care, the frequency of hospital caused illness (staff, antibiotic resistant germs, etc), and a lack of quality of care and quality of doctors in the current system. Socialize medicine is a joke, just ask Canada. Our government was not to be and should not be a "for profit" enterprise. however, at present, the government is the largest "for profit" entity in the USA. These same concerns should be addressed at the V.A. Hospitals in the USA and abroad as well. Best Regards, J.W.
And of those hundred employees, how many deal with the paper work of HMOs?
In Canada we have public health insurance. All doctors, hospitals, and labs charge for services offered, and send the invoice to the provincial (like a US state) Ministry of Health. Each citizen or person with landed immigrant status gets a health card which is used for billing. You walk into a medical facility, hand them your health card, and get the care that you need. Of course not everything is covered (dental, eyes glasses, chiropractors), but most larger companies offer supplementary insurance for these things.
Note that medical records are kept at your doctor's office (or at any hospital you visit), NOT in any central government databases.
There are also agreements between provinces, so if you're someone in BC and you go to Ontario and need to visit a hospital, you give them your BC health card and don't see a bill. All the transfer of funds occur in the background between Ministries.
So a doctor's office is basically a private enterprise, it's just that they don't need a huge support staff to get paid. Most offices that I've visited have one secretary for booking and paperwork, and maybe a nurse. The basic rule is that if you charge the public system, you cannot also take money from private insurance companies. You're either in the public system, or not: there's no "double-dipping".
Service is decent for acute care (if you have a heart attack), but for "quality of care" things (e.g., hip replacement) waiting lists can be a bit long since they're not treated as a priority. (Though there has been a push in recent years to get them down.)
To give numbers to this, in the 2003: per capita spending for health care in Canada was $3000, covering 100% of citizens. In the US for 2003, per capita spending was $5700.
http://www.kff.org/insurance/snapshot/chcm010307oth.cfm
And it should be noted that Canada is often not even considered the "best" in terms of health care.
Personally I never saw how profit-motivated health care made sense.