I say yes, you say no, OR People are Strange

I'm with Blue. I can choose what hospital to visit, although most of the time it makes sense to choose the only one in my town. In Canada, we do not have private services for the same things that are provided publicly (except for occasional exceptions). It is a public system - and woe to the politician who tries to change that.

Medigal -- No such thing as "in network" health providers up here.  As Blue says -- any hospital, any doctor, it's our choice ALONE.  Contrary to the anti-healthcare reform propaganda you have heard/read, the government does not stand between me and my healthcare provider.  My doc submits a bill to the healthcare ministry and is re-imbursed.  Oh wait, he might have his receptionist do it!

The "network" is the entire province. For example, at my local hospital it would have taken a while to get a PICC line put in so my oncologist sent me to one down the highway a bit to have it done more quickly.

When my daughter was born (over 30 years ago) she needed to be sent to a more specialized hospital for assessment. They GP set things up to go to a hospital to the east of here but I wanted one in the Big City to the west, so they rearranged things right away and sent her where I wanted. And she is OK.

The former Solicitor General of the United States under Ronald Reagan says that the mandate of the health care act is constitutional.  Here is a link to a YouTube where he explains his reasoning.

http://www.youtube.com/watch?v=-UGQIkYEBPo&feature=player_embedded

As another Canadian, let me reiterate what the other Canadians here have been saying.  

• I like being able to choose which doctor and which hospital I use. Yup, me too.  And I can.  
• I like being able to plan when to have non-emergency treatments to be the most convenient for my schedule and my family's schedule, not what works best for the government.  There are wait times for some non-emergency surgeries or treatments but I am free to find another doctor or hospital with a shorter wait time. This information is actually available on-line so I can do my research and pick my doctor/hospital.  If a procedure is scheduled at a time that it inconvenient for me, I can change it. As for day-to-day care, I usually get my appointments scheduled with my PCP within 48 hours (and often the same day if I really need to see the doc) and if that's not fast enough, there are lots of clinics in the neighbourhood that I can go to.   
• In an area like the one I live in with access to many hospitals, I can choose any of them.  Yes, there are many hospitals in my neighbourhood and I can choose anyone too.
• There are a variety of reasons that I choose a particular facility for treatment depending on the time frame, the issue that needs treatment, and that facility's reputation and location.  Exactly. When I was diagnosed with BC, rather than stay at a neighbourhood hospital, I asked to see the doctor who is the head of BC surgery at another hospital in town, one that happens to be among the leading cancer hospitals in the world.  It was not a problem getting in there. 

I can't say how a U.S. government funded single payer system would work - every country with a single payer system runs the system differently.  In the U.S. you might not have the freedoms that we have within the Canadian system to choose our own doctors, hospitals, etc..  But please don't make assumptions about the Canadian system based on concerns that you have about what might happen in the U.S..  And understand too that a government funded single payer system does not have to have all the problems and restrictions that you fear. There are many countries with this type of system that prove that. 

Some people have great insurance that allows them the freedom to choose who, when, and where. Unfortunately, many many people have plans that don't offer that freedom. Look at the postings on this board about women who can't get the kind of reconstruction they want because of their insurance plan. Not to mention, women who can't go to top rate cancer centers because their insurance either won't pay at all or will only pay at reduced rates. Of course, if you have enough money to pay out of pocket you can go anywhere you want. Unfortunately, that's not the case with most people. I think the argument that most Americans have complete freedom of choice is not grounded in reality.

I every woman on this board wants to be really honest, there are problems with insurance companies and problems with single-payer systems.  None of these choices are perfect.

PM Williams went to Florida for his heart surgery.  We discussed that some time ago.  He said it was his decision and his business.  Of course he had all the money he needed to have surgery done outside of Canada.  The rich can go anywhere in the world.

I don't believe our physicians would want to work for the government.  There are doctors dropping out of Medicare and Medicaid because of the reimbursements.  Some doctors don't take any insurance, thus cash only.  In many cases doctors are not being reimbursed enough to meet their overhead and still make a living.

My gripe about this entire process was to bring in many more people who worked in the health care field and business to discuss what were good options.  But it seems the legislatures who wanted this HC bill so badly just wanted it passed to say we did it.  It would be one of their geatest accomplishments.  It was an agenda and if you think otherwise you, IMO, were not watching the process which turned many American's stomachs.

I've seen small business owners testify that they cannot afford this.  It would be cheaper to drop their coverage for employees and let them buy insurance through the exchange.

This is a government run health care bill (legislation) no matter how you see it.  If the government can tell companies what they MUST cover it makes sense that it will be more costly to the consumer.

We have over 300 million people to insure.  There are people who qualify for Medicaid who have not signed up.  There are healthy young people who have not seen the need to buy insurance.  My BIL and SIL are in their 60s.  They have never bought insurance.  He will be going on Medicare later this year.  They are very fortunate that they have not had a  catastrophic illness or a chronic illness that requires expensive meds. 

We all agree we need reform.  It's like beating a dead horse to discuss it..pointless.  What Canada has may not work in the U.S.  And, as I have said before, most Americans are very impatient.  They want their cataract surgery, knee surgery, hip surgery, or any elective surgery done when THEY want it done.

I stand by my statement that NOBODY NEEDS health insurance.  People NEED access to care. 

If that care is delivered for free, or for a sliding scale fee in a clinic setting, no need for insurance.  If hospitals didn't overcharge private pay patients to make up for the cut rate deals they make with the insurance companies, the cost of hospital care could be slashed, so again less need for insurance.  If hospitals were truly non-profit again, without the huge CEO salaries, they wouldn't need to make money on patients, just cover actual costs.

Those who consume health care are part of the problem too.  Going to the ER for a simple ailment that could be easily handled in a doctor's office, or even over the phone with over the counter remedies, drives up costs and ER wait times for all of us.

There is little in that health care bill that addresses the astronomical and rapidly rising cost of health care.  At some point in the process, it became politically expedient to turn the health care reform into health insurance reform. 

notself, are you talking about the new health care legislation and specific plans?  If that's what you are talking about, it's very specific.  Some of the things that insurance companies are to provide are already in our insurance policy.

When I first moved to the US, a colleague wondered why my sister went into medicine if she can't become extremely rich.  I was shocked.  How about the desire to help people and the love of science?  To think that some doctors are only in it for a buck is awful.  BTW -- she does make a very decent living while doing something she loves.

There are stll some "non-profit" hospitals in the US, but even many of them have CEO's and other top staff members not involved in direct patient care who collect million dollar salaries.  A small hospital near me is constantly on the edge of bankruptcy yet is not only paying their current CEO a huge salary, they also bought out the contract of the former CEO who brought them to the edge of bankruptcy, and are still paying his salary too, even though he no longer works there.

Eliminating nonsense like that would go a long way to reducing costs.  This law does nothing about things like that. 

When I lived and worked in DC, my primary client base was not-for-profits. It is insane what the executive directors and other officers of these organizations are paid. When I hear NFP, I cringe.

I experienced excellent healthcare when I lived in the US -- it was as good as I can get in Canada.  Too bad everyone can't get this same good care in the US.  Hopefully, one day, a solution will be found.

Edit to add I had great insurance through my employer.