I received an email today from my family doctor's clinic telling patients to be less particular about whether they get to see their doctor or not when they schedule an appointment with... their doctor. The parts I take issue with are in bold. Here's the email body:
Good Morning <clinic> Patients,
A Reminder to Our Patients: <clinic> is Proud to Be a Teaching and Team-Based Facility.
Medical learners (students and residents, most of whom are training to be family physicians) are an important part of our team. Physician assistants, nurse practitioners, and locum/covering physicians are also crucial to our clinic functioning.
With the help of our team:
- We are able to offer non-urgent appointments usually within 1-2 weeks.
- We are able to offer same-day appointments for urgent issues.
- We are able to continue to provide care to our current <clinic> patients at a time when there are a record number of family physicians leaving practice.
- We play an important role in training the next generation of family physicians.
There have been an increasing number of patients requesting appointments with their provider only (and declining to see other members of the <clinic> team). This causes significant disruptions to the clinic and affects our ability to provide equitable care to all <clinic> patients.
Moving forward, when you book an appointment, you should expect that you may see a medical learner, physician assistant, nurse practitioner, or a physician covering for your primary family physician. For many appointments, your family physician will be available to see you after you have been seen by another practitioner, if requested or needed. Please be aware that learners and physician assistants are supervised directly by your physician.
This team-based model of care may not be the right one for you, and if you wish to transfer your care to another clinic, we will be happy to waive the usual fee for transfer of records.
We appreciate the important role you play in medical education and making practicing family medicine sustainable.
Sincerely,
The physicians and staff at <clinic>.
So basically, patients want to see their doctors instead of medical students and the clinic is telling the patients to fuck off with their standards and expectations. Instead of building rapport, confidence, and sharing personal vulnerabilities with your family doctor, you can now expect to do it with random, unqualified, inexperienced people who you'll never see again and who don't know your history. If you don't like it, despite paying these fuckers' wages, you can pound sand.
FYI, when this email says the students and assistants are directly supervised, it's figurative. It means the students and assistants report to the doctors, not that the doctors are in the room while the assessments and appointments are conducted. You're expected to meet with these unqualifieds one-on-one. There used to be supervised appointments where medical students would simply shadow the doctor with permission from the patient, but that hasn't been the case for years.
Also, moving to another family doctor is extremely difficult. Most doctors have a maxed-out roster and are not accepting new patients. There are 2.3 million Ontarians without consistent access to a family doctor in a province of 14.5 million.
Canadian tax dollars at work.
Does single payer hurt or help a nations healthcare system? I can see it both ways, economies of scale says it would help, the law of governmental incompetence and graft however says it could hurt.
I think the ideal situation is probably one of free market practitioners (doctors clinics etc) and a single payer approach to supplies, drugs, technologies. Perhaps also a low level government funded clinic system for the truly needy, which can like the OP operate as a kind of training area. You aren’t getting the best care possible but it also isn’t bankrupting you of what little you have.
Anyone with thoughts or insights on the matter to share?
Switzerland is doing okay. They aren't part of the Shengen zone or the EU and took much fewer non-White migrants than its neighbours.
The state is the single-paying insurer, and private hospitals compete, thus have incentives to meet quality of care criterias and efficiency.
We have nearly full public everything in Québec and even if mass-migration wasen't bleeding services dry, lack of efficiency due to total job security and administrative bloat would be fucking things up too ( but to a lesser extent ).
I have a relative who left Quebec to work as a nurse in a French-speaking Swiss Canton and she said she would come back and work here if the government unfucked the work conditions of nurses ( mandatory unlimited overtime, can't choose how many hours you work, etc. ).
But last time she came to visit her mother, she saw the place getting invaded by non-Whites and now she won't come back no matter what.
Attachment to her people was the only reason why she would have came back. Globalists destroyed that.
One of the best things about AI is that it has the potential to drastically cut down on the size of bureaucracies. Fuck the bean counters if they're gonna deliberately overcomplicate everything at the expense of everyone else.
In a utopia, it's the best way. The problem is utopia doesn't exist. I'd probably even be inclined to argue for single-payer in small homogeneous cultures. Because it could work there. As soon as you start adding diversity, it breaks.
For what we have somewhere like the US, if I had my way I would break up and make independent most of the doctors practices and not allow them to ally with insurance companies, let's just call that price fixing. You show up, you pay the rate to the doctor. Whatever insurances is between the patient and the insurance provider. I might be inclined to regulate hospitals a bit from a more governmental level (no larger than State government). Mainly just cost transparency and oversight type things. Insurances become as big or as small as the consumer wants to make it. Pay for it yourself, ok. Want to have a Church healthcare cost sharing plan, go for it. Faggots want to fund Buttsex United Health Corp to pool the money they don't have to pay for other faggots to deal with their doctoring needs, that's fine too. I'd likely also propose some sort of taxpayer funding for kids somehow. Adults can take their own responsibility.
That’s true. I know, for instance, Canada has straight up “sin taxes” where a pack of cigarettes or bottle of beer will cost 4x what it costs on this side of the border. So many people would cross the border just to shop for shit where I used to live, even taking the hit in currency exchange rates that usually would entail. I understand that the idea behind these extra taxes is that these people will supposedly go on to cost their healthcare system disproportionately. The funny thing is that I’ve actually seen data suggesting the opposite, that smokers and drinkers drop long before their healthcare costs hit the stratosphere, while “healthy” people in their desire to cling on later and later into old age actually end up “costing” these government healthcare systems more. So yeah, that big ramble was basically just to echo your point about how this is all basically based on utopian thinking.
Tangentially, the only thing actually that I see people buying from Canada and bringing/shipping here is, oddly enough, medicine and certain health products.
Boomers are terrified of death in a way that no previous generation of old people has ever been. Used to be that back in the day you just accepted dying as a fact of life, the moment you fell ill with common old people diseases like cancer or heart disease or kidney failure you just laid down and died. I wonder how many boomers, despite professing religiosity, either don't really believe in an afterlife, or fear that their degeneracy has landed them a spot in hell.
Not to mention that at a certain point, you just don't have quality of life anymore. Euthanasia is a slippery slope, however once you're past, say, 70, I don't think it's unreasonable to say, sorry, all we can offer from this point on is palliative care.
Aging is entropy's effect on the human body, and when you fight entropy, the law of diminishing returns will make costs go up exponentially. Why invest a given sum of cash to give a diapered fossil one extra year of life, when the same investment can give someone younger an extra decade of a much higher quality of life?
Realistically, this (an aging population, in a socialized healthcare system, clinging longer and longer as tech advances) is behind the push for MAID, and realistically most people wouldn’t have a problem if they didn’t hear about depressed teenagers or young people cripple by the vax being offered euthanasia
That I believe, because I've seen way too much of it first hand. I really don't understand it myself, maybe when I get to that point I will. They make Joe Biden look like a picture of youth and perfect health in comparison, yet will do anything to add an additional breath to their lives. I also hear of all these tricks to basically ensure the taxpayer pays for it all. Let's just say I don't get a warm response for suggesting that I've had a decent life and afforded enough opportunity that I consider it my own responsibility to make sure I'm provided for in my old age.
It depends on your perspective. From the perspective of the medical "professionals", it helps. From the perspective of the patient, it destroys it.
Isn’t the “reason” (obviously more complicated but just for the sake of discussion) that the prices for a procedure or drug are less expensive with insurance is because of “bulk purchasing”? The insurance company is buying 1000 MRI scans per year per hospital, so they work out a discount between eachother, then when you need one of those procedures or prescriptions it’s available “cheaper” (though after accounting for all the money you spent on insurance but didn’t get maximal “value” from, you might end up paying more than a guy who isn’t paying for insurance his entire life )
For example, I wouldn’t want my doctor to have to hire people at his small family practice to haggle with the insurance companies and the drug companies and the one-time-use sterile syringe companies, and disposable scrubs companies, and so on and so on, but right now they are almost forced to. If the state (or federal, but most constitutionally appropriate, the state) government handled the sourcing and purchase negotiations they would, ideally/hypothetically, have far more leverage in getting better prices than the small family doctor, the clinic, the hospital, or even the network of hospitals which is often the case these days. Then these supplies would be distributed at or near their total cost.
So all that is to say, I don’t see why the idea of a single payer system necessarily harms the patient or the healthcare provider, I see it mainly just cutting into the extortionate profits of big pharma/insurance companies and the “administration” departments of healthcare providers
It harms the patient because UHC increases the demand for medical services (since everyone is now "insured"), while doing absolutely nothing to increase the supply of medical services. Hence, people in Canada having to wait for two years to get in for hip replacements and shit.
That’s a fair point but what I’m saying includes delineating between the ideas of single payer and universal coverage/healthcare, we don’t have to mix their pros and cons in a hypothetical - my idea was a single payer system upto the point of direct patient contact (the provider)
I think that at least for a while in the UK the economies of scale net outweighed direct gov incompetence, until government incompetence from other areas of governance started to bleed over too.
It doesn't matter if the care is more cost efficient with your tax money if the government is also giving away unlimited healthcare to huge numbers of people from fictitious warzones with almost zero verification and zero contributions.
It's also harder to be efficient when it turns out the supposedly smart people you selected to use the resources effectively were actually graded more on a color chart than a results table by the education system and are barely more effective than a flowchart with pills taped the end of each branch.
Just do it exactly like student loans. If you can't pay, you qualify for a low/zero interest loan to cover the cost which you can pay back whenever, but can't be discharged via bankrupcy.
This keeps the benefits of a market while also ensuring the poorest Canadians can access healthcare.