Chaos!

Summer 2000 CSANews Issue 35  |  Posted date : Mar 05, 2007.Back to list

Canada's medicare system is under stress! More than $4 billion dollars have been cut from the provincial transfers to the provinces, and these monies were used primarily for education, and guess what ­ medicare. The provinces and the federal government have been meeting in an attempt to resolve, what many believe to be, a crisis situation. Simply reinstating the old funding just cannot be enough to solve the problem.

The costs of the new "designer" drugs, which can be so effective in treating our many diseases, are astronomical. The new medical technologies used for both testing and treatments are far more costly than the old, traditional methods. An MRI (Medical Resonance Imaging) machine, for instance, costs approximately $2,000,000 to purchase, and about the same amount to operate, every year. This is as opposed to the old X-ray machines that cost substantially less, both to purchase and to operate, and which are far less effective. I heard a statistic that the city of Cincinnati had more MRI machines than the entire country of Canada, at one point. Funding! And the MRI situation is only one small issue among the thousands our governments have to address.

Waiting lines for life-saving operations, months of delay in being referred to specialists, and more weeks and months prior to proper treatment. Doctors and nurses trained in the new technologies are at a premium; finding professionals to work in our rural areas is very difficult and expensive; not enough of almost everything, but especially money. We have not even addressed the very important issue (and cost) of research and its implementation. One of the ugly methods of reducing medical costs is for governments to drag out the approval process for new drugs and new treatments. If they are not approved, then they are not paid for. What is the real cost in human suffering and in lives ended, which might have been saved? This is a medical system in chaos.

The tremendous advances in DNA research and genetic coding are very close to providing us with those elusive cures for cancer, and the many other deadly diseases, but how can we possibly afford them if we are having trouble supplying a simple bed for a simple operation?

This began as an insurance report, and I was simply going to outline the ridiculous position of the provincial governments in paying a lousy $75, or $100, or even $400 per day towards hospital costs outside of Canada. In the U.S. hospital bills we at Medipac pay, I have seen aspirins that have cost $100, literally. My apologies, I get carried away sometimes, well maybe often, just thinking about our wonderful health-care system being frittered away by our governments. The real cost of health care in Canada is far, far higher than the amounts we receive from any provincial health plan for our out-of-country bills. Did you know that Canadian hospitals routinely charge $2-3000 per day to treat non-Canadians? The Canada Health Act guarantees us that our medical costs will be covered, anywhere in the world, at the same level as in Canada. This is the law ­ the government's law.

As real medical costs go up, and we can see why, the natural corollary is that insurance costs go up. The federal government originally agreed to split the cost of medicare equally with the provinces; it is my understanding that they now pay only about 15 per cent. The provinces agreed to pay the normal medical costs in Canada, while we were away; they now pay less than 10 per cent of medical costs incurred in the United States. Medical inflation in the United States will be in the area of 15 to 18 per cent this year, and this means that rate increases will be coming. How much? We're still fighting for reasonable numbers and we won't know the outcome until next week; hopefully, increases will be a lot less than these numbers would indicate.

We have done some amazing things at Medipac Assist to control our U.S. hospital and physician costs. Some of our large bills have been settled for 20 cents on the dollar, due to the excellent contracts we have negotiated with our many hospitals. More and more U.S. hospitals are recognizing Medipac as an excellent new source of patients, and therefore income, and they don't have the payment problems that traditionally come with out-of-state patients. These savings go directly back into our program, to help reduce inflationary rate increases.

I want to explain one of the changes we made to our "Early Bird" plan regarding CHF, which means congestive heart failure. We found that some of our clients were not aware, or did not understand, that they had CHF. As such, they answered "no" to that question and qualified for Preferred Plus rates. Several claim problems arose when they experienced CHF complications while travelling. We have successfully resolved most of these claims for our clients, but we felt it necessary to address the issue so that future claims would not be denied. Congestive heart failure is often referred to as "water on the lungs," and this is what caused some people to be unaware of their condition. The drug Lasix is used as the most common, successful treatment for serious cases, and we decided to add an additional question regarding Lasix use. This will avoid any future misunderstandings when it comes time to make a claim. We felt that anyone who had congestive heart failure should be paying Standard rates, and we hope you will agree with our decision.

I'm now out of space, but I would just like to remind you that it makes no sense to be angry about our health-care system unless you tell the people who can change it ­ your friendly politicians, who desperately want your vote. The next First Minister's Conference is slated for early September, and health care will probably be the driving issue. More next month.