Comment by jjmarr

Comment by jjmarr 2 months ago

This takes place in Canada. There are no for-profit hospital complexes like the USA. All of our major hospitals are non-profit, reimbursed by the single-payer healthcare system and philanthropists getting stuff named after them. The profit-motive isn't as significant of a factor here.

That being said, I'm fine with a reduction of resources if additional resources don't increase the quality of my care. In Canada, doctors don't really like to prescribe antibiotics for minor infections.

Americans find this bizarre, but for a minor infection antibiotics are going to screw up your stomach bacteria and long-term health to maybe treat a disease that your body can easily handle on its own.

There's no magic value that comes from allocating resources to a problem. Oftentimes spending money has zero or negative impact beyond virtue-signalling that you care about the problem.

llm_nerd 2 months ago

Canadian hospitals have largely the same cost cutting and "efficiency" measures as their US equivalents. Departments have budgets that they have to fight for, feifdoms compete for scraps, and there is an enormous and perpetually growing admin/executive side that is taking more and more of the budget. Couple this with governments such as Ontario that "starve the beast", so to speak, forcing hospitals to squeeze further.

I don't think we should ever take any sort of superior position on this. The same motivations and outcomes occur.

Having said that, efficiency is good, especially with an aging population that will require more and more care. Resources are limited, so applying them in the most effective, efficient way possible is always a win.

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jjmarr 2 months ago

American healthcare spending 80% more than Canada on a per-capita basis for worse or equal outcomes.[1]
Our system has major problems, but we spend less money and have a healthier population. That definitionally means we're more efficient.
> The same motivations and outcomes occur.
Our hospitals don't have shareholders that capture excess revenue as profit. Efficiency gains in a non-profit hospital typically get reinvested into the mission of providing healthcare. Efficiency gains in a for-profit hospital often go to the owners.
"Efficiency" is also measured differently in a non-profit context. A business measures monetary return on investment. A non-profit organization measures the monetary cost of achieving its mission.
Many for-profit hospitals in the United States offer free mental health clinics. These clinics have been accused of baiting patients into saying something suicidal as a tactic to involuntarily commit said patients.[2] Because appeals of an emergency mental health order are difficult, this is an extremely efficient way of making money (the hospital gets to bill the patient for their stay).
I don't believe this could happen in Canada. The goal is to get people out of the hospital because there aren't enough beds.
[1] https://en.wikipedia.org/wiki/Comparison_of_the_healthcare_s...
[2] https://www.buzzfeednews.com/article/rosalindadams/intake

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- ywvcbk 2 months ago
  
  > Our hospitals don't have shareholders that capture excess revenue as profit
  Aren’t most hospitals in the US technically non-profit, though?
  
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- llm_nerd 2 months ago
  
  I will always choose properly funded universal healthcare over the US model, and my disagreement was with the claim that somehow the Canadian system wouldn't yield a reduction in resources because of some unique quality of universal/non-profit healthcare. Of course resources would be rebalanced if some part of healthcare could be done with less, and if the administration could cut budgets because a model lets them hit the same benchmarks with less, they absolutely, unequivocally will. And then they'll give themselves a fat bonus.
  As to the mental health holds, here in Canada we have a problem with social workers encouraging difficult cases to consider medically assisted suicides, which is pretty disgusting. We have people dying on waiting lists. We have people having to go to the US to get basic imagining of probable cancer cases.
  Universal healthcare is superior -- again assuming proper funding, which jurisdictions like Ontario are far, far short of -- but in the current state of the Canadian system, I would never imagine bragging about it online.
  
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jmward01 2 months ago

I totally agree. The tie to whole patient outcome is stronger in that system. Still not perfect, but a lot more direct for sure. It may be an odd thing to say, but because of that there is an argument that the Canadian system is closer to a true free market healthcare system with the patient as the consumer than the US system.

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