Ontario nurses fleeing Canada for American jobs

[Seven&wyo]

Yeah, why have a nuanced look at things that incorporates the thinking and approach of medical professionals when you can just use your daddy as an example and label everyone as lazy slobs and gluttons. Did a fat man hurt you? There must be something deeper here to trigger your hate of anyone with a higher BMI than you deem appropriate.

Are you ignoring the stats that I previously pointed out or are you this fucking dense.

[southen]

Are you ignoring the stats that I previously pointed out or are you this fucking dense.

You do understand how each person has different health issues, different genetic factors, different environmental factors, that lead to ailments, right? I get that you don't want to pay for the poor health of others but we all contributed to the public school system that churned you out and your complete inability to understand that health and health outcomes are more complex than just not eating a Big Mac.

[Seven&wyo]

You do understand how each person has different health issues, different genetic factors, different environmental factors, that lead to ailments, right? I get that you don't want to pay for the poor health of others but we all contributed to the public school system that churned you out and your complete inability to understand that health and health outcomes are more complex than just not eating a Big Mac.

So you are that dense, got it. Alright southen this was fun.

[Zacha341]

And that is were it will remain -- dust-coated. Been there - done that!

I now have one of those foot peddlers and have put 175+ miles on it. It's kept where I can get to it fast -- usable.
Going no-where mind you, but it works when I can't cycle outdoors...

Remember the last line of the commercial, "and it folds flat for easy storage under your bed..."

[Vic01]

So you are that dense, got it. Alright southen this was fun.

Maybe we can get back to the original topic now

"Ontario nurses fleeing Canada for American jobs"

[Rocket]

Maybe we can get back to the original topic now

"Ontario nurses fleeing Canada for American jobs"

Yay USA! And Thank you Canada!

Nursing is a job I wouldn't do for all the money there is, so I'm, glad there are people willing to do it, and also glad Canadian nurses are coming here.

There is a perpetual nurse shortage, and it's often filled with nurses from the Philippines and the like. Having native English speaking nurses come here from just over the bridge is even better.

[Richard]

NorthShore will be required to pay $10.3 million to employees who were denied religious exemptions.
Mat Staver, founder and chairman of Liberty Counsel, was behind the settlement. Staver explained on "Fox & Friends" Tuesday that NorthShore implemented a "jab or job" policy, meaning employees were required to get the vaccine or be terminated.

https://www.foxnews.com/media/health...ig-wakeup-call

Nurses could also be fleeing in order to experience the freedoms and protections that working in a republic has,verses a democratic dictatorship.

[Wesley Mouch]

Average Canadians lifespans are 3 years longer than those in the USA. ...snip...

This appears true, but comparative quality of the healthcare systems is not likely the biggest factor. Were that things were so simple.

Canada has a forced single-payer system, with near-zero tolerance for private care. They are an outlier, with most other government-run healthcare systems allowing some private care. Close proximity to a fee-for-service healthcare enables them to try to hold this moral high ground.

What's going to happen now in the near future is a 'stress test' of the Canadian system. Their system is a top-down managed system where [[virtually) everything is managed by bureaucrats funded by politicians. Its not just single-payer, but single-management. That's the weakness. Healthcare north of us is decided in smoke-filled rooms or by faceless administrators. Innovation arrives when its allowed, and not a moment before. Think about the joys of having your wait for healthcare managed by the same people who manage our Secretary of State's offices.

[Canadian Visitor]

This appears true, but comparative quality of the healthcare systems is not likely the biggest factor. Were that things were so simple.

That's fair, a closer examination would reveal multiple things at work in that difference; they range from lifestyle issues to crime levels to yes, health systems. But, on that latter point, you'd find some conditions for which outcomes are demonstrably better in Canada, some that are better in the U.S. and many that pretty close to interchangeable.

Canada has a forced single-payer system, with near-zero tolerance for private care. They are an outlier, with most other government-run healthcare systems allowing some private care. Close proximity to a fee-for-service healthcare enables them to try to hold this moral high ground.

This statement lacks nuance. Doctors in Canada are free-standing independent businesses, not employees of the state.

There are no quotas or funding limits as it pertains to procedures performed by or prescriptions or referrals made by doctors. Hospitals manage their day-to-day care without discussing anything with government bureaucrats.

That said, governments do have certain de facto controls over the volume of some types of procedures.

They generally control hospital base budgets which include overhead/admin, porters, nurses and others who don't bill for procedures/performance.

In that way, they may impact how many dollars a hospital has available to operate O/Rs as an example.

The government generally also controls access to expensive procedures insofar as it funds the purchase of equipment or the operating hours for certain things.

An example here would be PET Scanners. Your doctor decides whether you need one, the government does not. But the government does decide how many Scanners exist, where they are located, and how many 'base' hours are funded in a dedicated budget [[hospitals routinely operate machines beyond government allocated hours from their general/base funds)

What's going to happen now in the near future is a 'stress test' of the Canadian system. Their system is a top-down managed system where [[virtually) everything is managed by bureaucrats funded by politicians. Its not just single-payer, but single-management. That's the weakness. Healthcare north of us is decided in smoke-filled rooms or by faceless administrators. Innovation arrives when its allowed, and not a moment before. Think about the joys of having your wait for healthcare managed by the same people who manage our Secretary of State's offices.

Again, this is substantially wrong. I outlined the gist above.

That said, yes, the system in many provinces is under stress and Ontario's more than most, as it has comparatively fewer hospital beds and nurses relative to population.

A variety of actions are under way to address this in the medium term [[example, Ontario just approved 4 new medical schools to begin operating); but there is an obvious lag time on many changes [[graduating new doctors takes ~ 7 years).

The key stressor is the short term 3-5 years in which Ontario needs to fill personnel gaps before newly trained people are ready. This will almost certainly need to involve licensing foreign doctors who are already here, but heretofore have been unable to get a residency or waiver of the need for same. This is in the media and I expect some resolution will be forthcoming soon, but even then, it likely take a year to see a material difference.

Additional beds and equipment have been approved, but there is a lag time for construction, obviously, so Ontario/Canada is now living with having deferred some investments during a period in which balanced budgets and/or lower taxes were given priority over enhanced healthcare investment.

The next year plus will a severe challenge.........but beyond that things should improve.

[Richard]

“ An example here would be PET Scanners. Your doctor decides whether you need one, the government does not. But the government does decide how many Scanners exist, where they are located, and how many 'base' hours are funded in a dedicated budget [[hospitals routinely operate machines beyond government allocated hours from their general/base funds)“

So in other words,the government controls the level of healthcare one receives or if they even receive it in the first place.

Physical excess to healthcare is the limiting factor.

Italy has free healthcare,or healthcare for all,providing you can get to the hospital that is 100 miles away and the government has stocked it.

I do not think things will improve,in no country where they have free healthcare for all has it ever been in a non critical state.

Did the nurses and doctors from Canada just decide to migrate or flip across the bridge to work in the states yesterday?

Also with the link I provided,what did anybody really think would happen when you already have a shortage of nurses then say no shot no work.

It is not hard to search how many hospital staff were fired for not getting the shot.

The hero’s of yesterday became the PÓS of today,then people wonder why they cannot fully staff and refuse to look at the numbers of how many other lives were lost because of the delay in receiving healthcare.

What happens in Canada if you are in the middle of an operation and the pencil pusher steps in and says,sorry going to have to sew you up next week when the budget funds come in.

What if you look to receive healthcare and it is towards the end of the budget and there are not enough funds to cover it,go back home?

You cannot say it will carry to the next round of funding,because you would always be in the negative,which you are already.

So the reality is,when you go to the doctor,there is a man in a room and doing the math who will determine at what level you will receive it.

It goes back to the claims that a person who is within a certain age group and how many productive years they have left will determine their level of care.

In Canada that number is age group 20 - 45 outside of that the man in the box will determine what level of health care you will receive.

Go back to 2008 - this is now 2022

The current health system does not have a 'management' problem; it has an 'economics' problem. The looming crisis in our system has three identifiable causes: the government's monopoly over funding for medical care, the politically planned allocation of medical goods and services, and the lack of consumer exposure to the cost of using health care.

https://www.fraserinstitute.org/arti...gement-problem

Hard to say something is getting better when it is no different then it was 15 - 20 - 30 years ago,nothing has changed.

Canadas healthcare represents 11.8 % of your entire GDP and there are some provinces that are and have been underfunded on the adverage of $250 million per year.

You are spending over $280 billion plus per year in order to provide healthcare to less then 38 million residents.

At 23 billion per year your defense budget is 2 billion less then what you spend on illegal immigration per year.

The United States per capita healthcare spending is just shy of $11,000,we already have and have always had healthcare for all.

Canada per capital spending per person is $5000,so at the very minimum Canada would have to double their healthcare investment in order to reach the same level that the United States has,such as it is.

There is no way possible for Canada to achieve that without bankrupting the country.

Canadian healthcare structurally mimics Sweden,who spends 10% of GDP on healthcare,and offers free dental for under 21.

But do you know the difference?

1. In 2010, Sweden made private healthcare insurance available. The use of private health insurance has been increasing due to the low number of hospitals, long waiting times to receive healthcare, and Sweden’s priority treatment of emergency cases first. In Sweden, one in 10 people do not rely on Sweden’s universal healthcare but instead purchase private health insurance. While the costs for private plans vary, one can expect to pay 4,000 kr [[$435) annually for one person, on average.
   
   
   

In 2018, Sweden reached its record highest GDP [[PPP) per capita of almost $50,000.

https://borgenproject.org/10-facts-a...are-in-sweden/


So even in Sweden with the extremely high tax rate to pay for what they are admitting has problems they still cannot find enough funding.

Imagine what would happen in Canada if they changed that $5000 to $50,000 in order to pay to fully somewhat fund their healthcare system?

The reason nurses and doctors are fleeing Canada,because there is no public healthcare system in the world that works and they do not have to cross an ocean to flee,it is easy.

[Wesley Mouch]

...snip...
This statement lacks nuance. Doctors in Canada are free-standing independent businesses, not employees of the state.
...snip...

That suggests Canadian provinces are not 'single-payer'?

What percentage of their revenues come from other than provincial gov't?

The next year plus will a severe challenge.........but beyond that things should improve.

Your details are interesting. Do you believe that more central planning now will solve all the problems created by past central planning? Colour me doubtful.

I believe that while you've painted a picture of a wonderful ship with just a few problems that are just waiting to be solved. But they weren't. And there are no more problems around the corner. No. Everything will be great.

Central planning is wonderful.

[Canadian Visitor]

That suggests Canadian provinces are not 'single-payer'?

No, I did not suggest that.

A single insurance company for 'core' health services is single-payer.

But that insurance company does not decide which procedures go to whom or precisely how many are done.

What percentage of their revenues come from other than provincial gov't?

Every hospital will have a slightly different breakdown, but here's the financials from UHN, the province's largest hospital network:

https://www.uhn.ca/corporate/AboutUH..._2020_2021.pdf

Just over 60% of UHN's revenues come from the Ministry of Health acting as the insurer.

Other revenues include grants, endowments and trusts, the University of Toronto, ancillary services, income from on-site retail, parking, phone/cable/internet for patients [[not an insured service) etc.

Your details are interesting. Do you believe that more central planning now will solve all the problems created by past central planning? Colour me doubtful.

That's like asking whether you believe that the absence of coordination, regulation and a public option in the U.S., are the answer to the problems of uninsured and under insured Americans, excessive pricing/gouging on hospital procedures and prescriptions, and unnecessary tests and procedures.

Which is to say, the system is not wholly centrally planned, but portions of it are; that is largely unavoidable and a common facet of healthcare globally.

Those portions that necessarily planned will, invariably have good periods of high innovation/investment and poor periods an these will also vary across different sub-sections of the Healthcare system at any given time.

Of course our system is imperfect, and it remains such and will remain such.

As is the U.S. system.

The idea here to be able to express that with nuance.

I believe that while you've painted a picture of a wonderful ship with just a few problems that are just waiting to be solved. But they weren't. And there are no more problems around the corner. No. Everything will be great.

Central planning is wonderful.

I said none of this, and you would do well to stop putting words in the mouths of others that they neither spoke nor typed.

***

The problem here is not that you observe that the Canadian [[really Ontarian for our purposes) healthcare model has its problems. Duh!

Rather, its that you insist they are worse than they are; and that the U.S.has a model that would work better.

Con't below in next post to keep things readable.

[Canadian Visitor]

So again, noting that Canada/Ontario has many areas in which its healthcare system can and should perform better; is it really poorer on quality of care than the U.S. taken as a whole?

Lets look at the hard data shall we?

Maternal Mortality Rate [[mom who die during child birth per 100,000)

U.S. 20.1
Canada 7.5

Reported medication/treatment errors

U.S. 12.6% of patients
Canada 10.4% of patients

Source: https://www.healthsystemtracker.org/...tment-outcomes

Or

Consult this piece in the Washington Post on a Commonwealth Fund report, which is not overly flattering to Canada which had the 2nd last spot for outcomes vs dollars spent.

But which did rank Canada well above the U.S.

https://www.washingtonpost.com/wp-ap...GFA.jpeg&w=916

***

Lets talk other outcomes, Canadians with Cystic Fibrosis, live, on average, 10 years longer than their American cousins.

https://cysticfibrosisnewstoday.com/...han-americans/

****

Or lets look at an American publication, Newsweek, which ranks hospitals around the world each year.

https://www.newsweek.com/best-hospitals-2021

Here, you will find that Toronto has 3 hospitals in the Top 30 in the world, 4 in the top 59

That's more top-rated hospitals than New York or any other U.S. City.

****

Again, the point is not that Canada is perfect or our health system is; neither is true.

There's lots to improve on.

Wait times should be shorter, more advanced care should be offered outside the largest cities, we're too reliant on C-Sections for child birth; we under-utilize PET Scanners and we could use some more 'customer service' at times; we also need more comprehensive insured coverages for things like prescriptions and dental which have major coverage gaps.

I just can't stand your propensity for one-sidedness

[Zacha341]

^ Does America's larger population impact stats/ outcomes to some extent?

I ask this setting aside maternal mortality risks which INDEED are very high here in the US, granted. Especially among poorer populations.

[Canadian Visitor]

^ Does America's larger population impact stats/ outcomes to some extent?

I ask this setting aside maternal mortality risks which INDEED are very high here in the US, granted. Especially among poorer populations.

I think the answer is again complicated....

A larger country by population, with similar economic resources, will be able to afford at least some more advanced healthcare, insofar as the cost of that care is distributed across a much larger population.

However, a larger geography also creates impediments to accessing that care. This is true in the U.S. and Canada. Is advanced care in NYC or Cleveland or Minnesota available to you if you live in Washington or Hawaii or Alaska or Fla?

Your insurer may pay for the procedure, but probably not the flight, and maybe not the hotel for days required beyond the medically essential care in a hospital.

Its blurry.

***

Likewise, in Canada we have world-leading care in a small number of centres. Example, double-lung transplants at UHN; but while, generally various provincial insurance schemes will cover the procedure should you need it; whether they cover travel and non-medical accommodation is a different question.

***

Put simply, comparisons are hard. Outcomes are somewhat easier to measure as opposed to procedure counts or even wait times...

But even there, there are limitations.

What role do does acute-poverty play; or extraordinary wealth, not just in ability to access care; but in the conditions one may be likely to have in the first place?

***

The important thing to understand is that neither 'system' is in fact a 'system'........and neither system is perfect.

Canada tends to produce fewer terrible outcomes; the U.S. tends to provide more 'excellent' outcomes.......

But even both of those are not universally true.