Marianna,
Thank you for the insightful information about the Canadian system (as well as a little bit about others).. So, in your explaination of some two-tiered systems, what I hear you saying is that the services are available via taxpayer funded "public" systems and the "cost" is you have to wait a bit longer perhaps (depending on the severity "number" assigned), and also private facilities are still available whereas the "cost" is you have to pay out of pocket for it in return for little to no waiting time. So, what that tells me is a couple of things.. a) if you can afford it, you more than likely would opt for the private services paying out of pocket, but what that means is that you actually pay for that treatment twice (once to the government who provides it whether you use it or not and the other out of pocket for the private facility), and b) one could argue that the public education system in the USA is broken, broke and ineffective, which is why many of us have no confidence that a government run healthcare system would end up in a different place than our public education system.
I can see how it might aid in keeping prices in check to a certain degree. It largely depends on how long the waiting time (availability of services, specialist, etc..) there is. Many people's threshold for waiting for certain things are directly proportional to how much they're willing to spend privately to get it done faster and more efficiently. The prices you quote about MRI costs in the USA are about right, however that's WITHOUT INSURANCE; purely out of pocket. Most Americans have insurance. What insurance companies do (part of it) is they have a negotiated rate with the Medical Facility. So, someone without insurance and pays out of pocket really pays for their "service" and partially towards the cost of the "service" of people who get the "service" but don't pay for it (because they can't or don't want to). The person with insurance however, may be "charged" $1,000 to the insurance company for the same "service" and then it's up to your insurance plan on what portion of that you pay vs the insurance company.. With many HMO plans (like I used to have), my diagnostic MRI didn't cost me anything at the time of the MRI (granted, I still paid my premiums, so it really did "cost" me something but I would have paid that anyhow regardless of the MRI.. Other plans, like the one I have now has a $1,000 annual deductible and then insurance covers 80% of the cost of what's left over. So, the same diagnostic MRI for me under the plan I'm on now (assuming I had met my annual deductible), would have been about $200.
Incidentally, it's not ALL about profit for the prices charged for non-insurance people. As I stated, a portion of that "cost" also pays for the billions of dollars each year of services that are given away for free (either by choice or law). Already in this country, if you go to ANY Emergency Room, they MUST treat you without regard to your ability to pay. What ends up happening (and has to a LARGE extent) is that many people who are here illegally (and hence, don't have insurance) go to the Emergency Room knowing they can't be turned away for regular check ups, for sneezes and coughs, etc... not true "emergencies". That, in part, raises the "cost" paid by everyone else most notably those people without insurance that ARE willing to pay for it.
I pasted that link so that you (and others) could see the story in it's entirety. Not what *I* said, but the full story about what was out there. I, and many other Americans, feel that waiting 1 month for an MRI (for example) is far too long to wait, let alone 4 months. In our current system, I can schedule and have an MRI done in a matter of days. When my AN was diagnosed, I had my MRI done within a week of when my doctor asked me to get one, that was on a WednesdayI believe. By the next day, the doctor had called me on my cell phone and said something was found and to call his nurse on Friday to get a referral to see a specialist. I called Friday and by the following Tuesday, I was in speaking to a Otologyst. Another example recently was when I saw a doctor about a knee problem. He asked me to get Xrays and within a week I had them done. He told me that I needed to see an Orthopedic specialist. Within 10 days of seeing the doctor that told me to get xrays, I was in seeing the specialist. Was it life threatening? No...but, within a system like you described, I would have to wait 1-4 months to get the xrays that the doctor needed me to have done. For many of us, that's entirely too long even for non-emergencies.
I agree with you that costs are a major factor in the Health sector right now.. Things are just too expensive. So, that begs the question (I've been begging a lot of questions lately..
), how do you control the costs? For many of us, we think it's small, targeted legislation aimed specifically at lowering the cost... For example, tort reform (the amount that you can sue a doctor or hospital) is a MAJOR contributer to the cost of things. Another example, forcing hospitals/doctors to treat non-emergency patients who can but do not pay or who are not here legally and have no intention on paying. There are other needed "changes" to our system, like removing the lifetime cap on coverage (for those insurance plans that have it), doing away with the "pre-existing condition" that allows insurance companies to NOT cover someoone, not allowing the insurance companies to drop someone because of how many claims (or how much), etc.. Some have the potential to affect the costs (either up or down) while others do not.
What many of us object to is ramming this monstrous law into place when it was very plainly against the will of the people of this country. I saw poll numbers in the range of 75% of people who are/were against this law as a means for "fixing" the problems in the current system. Most people do not feel that THIS law is going to do what the politicians say it will. And, many of us object to the way that it was put into law (back room deals, behind closed door meetings, secretive about the actual content of the bill, parlimentary procedures typically used for budgetary only items, etc..). It was absolutely aweful how it was made into law AND against the will of the people they claimed to represent.
Regards,
Brian
