I don't understand all the bleating about "two tiered" system. Wouldn't people who voluntarily take themselves out of the system by paying for private care be helping the ones still "in line" for medicare?

By the way, aren't we creating a "two tiered" system when we let unelected judges make decisions like this rather than the elected officials who supposedly represent us?

   

   

I'll explain: the worry starts with the suspicion that the private care facilities would be able to pay more (or be otherwise more attractive as places of employment). The basis of the fear of two-teir is that there are a finite number of doctors / nurses, and the private sector (being more attractive as employers) would depleat the public human resources so that the public system's standard of care would decrease. This means that only the elite few who could pay would get supreme care, while the vast majority of folks using the public system get a lower standard of care than we get now.

This is speculation, with a rather grim view of the the possibilities, and I'm not sure I agree... but I do admit this is possible. My preference in changing the current system is to maintain a single public insurance system but open the door wide to private service providers. That way, the new and improved facilities would be available to everyone (one-tier, but better over the status quo).

   

This makes sense. Of course there could be so many possibilities, who knows? At least, they should improve the current public system either way. Like you said also, there are already a shortage of physicians as it is, they could all go to the private sector.

   

If the level of public funding was maintained for public health care then the arguement for private clinics having superior care and the public hospitals having inferior care, would be rendered null and void. It is a matter of timely access to services rather than the quality of services that concerns most Canadians. By shortening the waiting line in the public facilities it helps everyone in the end.

I have lived in Taiwan for several years and they have a system based on your income for premiums. The employer pays 60 %, the government 10 % and the employee pays 30% of the premium. Four years ago, I was suffering from severe headaches and when I was taken to the hospital, I had an x-ray, CAT scan and an MIR all done within a couple of hours. In the end it cost me the grand total of NT$ 1 300. That is about $ 55 Canadian dollars. The biggest problem with their system is the same one that faces Canada, people abusing the system by going to the doctor and hospitals when it isn't necessary and tying up resources.

   

Yeah we need user fees for small things you really shouldnt be going to the emergency room for

   

The problem with that is, how do you know if something is minor or serious until you see a doctor? This idea presupposes that people know what can wait and what can't. With the "user fees for small things" you propose, someone who couldn't afford to pay for something minor might decide to delay a diagnostic visit, to the risk of their medical health.

   

I'm talking about idiots that are to cheap to buy bandaids stuff like that. or something that could be treated the next day at by there doctor. ER is expensive think it costs 2x as much as a visit to the doctor

   

I'd say the solution to that problem would be to run a walk-in clinic in every hospital, so the ER could refer non-emergencies over to the less expensive care on site. It is a fact of life now that some people don't have family doctors, and they just don't know about walk-in clinics, so public awareness and easier access to these clinics is the answer. User fees only punish the poor for being poor.