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Thread: I am in shock...

  1. #1
    Join Date
    Jun 2008
    Location
    GTA Ontario Canada
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    12,264

    I am in shock...

    I am literally in a state of shock as a result of what I have just uncovered.

    Background. I need to have my knee looked at by a orthopedic specialist. Started out seeing my doc back in July. At the time went for Xray and doc ordered MRi which eventually happened in mid September. Then saw my doc next day and he went about requesting appointment with specialist. Been waiting two weeks and no feedback on appointment. This knee is affecting my mobility and quality of life. So I call docs rooms today to find out what is happening only to get told can expect to wait a further 3 weeks at least before appointment and then 3 months after that to see the specialist. So there is the first shock. So I asked if I could speak to my doc to discuss a new strategy. He will call me back, if not must make an appointment to see him.

    Ok so that's not even the shocking part.

    I got to go digging on the health ministry website, thinking like a business man I though mmmm I guess my case don't have the right $$$ attached to it so the specialist is "triaging" the case based on income.

    Well wrong. The shocker is I am amazed we have any doctors at all. The general perception is these guys are the cause of our high cost of healthcare again WRONG. They get paid peanuts from my understanding of the schedule of benefits for doctors in Ontario.

    If I ended up having an arthroscopy the surgeon would get $97.50 for the setup and $192.00 if he happened to remove a couple of bits of loose pieces in the joint.

    The initial consultation would get him $83.10 and a follow up visit would get him $51.70.

    How on earth can you expect a guy that's capable of this kind of skill and knowledge to stick around after education if he gets paid peanuts.

    A service of less complexity by a mechanic at a car dealership costs more....I have yet to leave a dealership with anything under $750 as the bill unless it was just an oil change.

    I have never dug into this issue like I have now, I downloaded the schedule of benefits that is open for all to see and its scared the wits out of me. No wonder the wait is so long. No wonder our emergency rooms are crowded. No wonder when I was having my shoulder treated after dislocating it, the doc spent a total of less than 5 minutes with me he cannot afford to get into discussion and give you time of day at these rates.

    And the never ending flow of bulletins from the gov means he needs at least three permanent and able bodied administrative types with accounting background to be able to file his claims and deal with the never ending change in rules and fees.

    Its scary stuff when one gets past basic need for a prescription. Pity the poor frail and aged in a home for a GP to make a call on a home he gets less than $50.

    As a further example not that I need one, cataract operation nets a ophthalmologist a mere $397.75.

    Of course nobody I have spoken to in my circle or in business is aware of these rates or the bigger picture implications they just happy they aint paying, but they are just indirectly.
    I am quiet in shock and wrote to the minister of health but that's like writing to the fox that guards the hen house.

    The real money is being spent in the bureaucracy and by the bureaucracy on managing it and man in the street thinks its the doctors getting rich. I am amazed they have not all gone elsewhere given the investment they made in time and money on their education.

    Its not that I did not know the system was like this I just did not know the facts about what they get paid and now I can see the implications on the wait times.
    In addition were I a doc faced with these "Rules" I would play the game of selecting and issuing appointments based on which case would net me the biggest return and pad the rest of my time with the lesser income cases when and if I have the time available. That would explain my case.

    Now I have to plan my next chess move....in the game to get my knee fixed. So much for being active.
    cheers

  2. #2
    Join Date
    Feb 2012
    Location
    St. Catharines, Ontario, Canada
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    2,749
    I wish you'd posted a link to that fee schedule, Rob. I agree that our Health system isn't perfect, but in my two heart attacks I got immediate and excellent care and am recovered. I had to wait two or three months for each of my four eye surgeries, but I was blind in one eye, and the condition wasn't life threatening. I understand about your knee, but it is part of the price we pay for 'free' medical services. (Our employees pay a payroll tax to fund the system, but I could never have paid for the amount of care I have received.)

    Anyway, could you post that link? I'd like to know what my quad bypass cost.
    Cheers,
    Roger


    The other member of Mensa, but not the NRA

    Everyone is a self-made person.

    "The thing about quotes on the internet is that you cannot confirm their veracity" -Abraham Lincoln

  3. #3
    Join Date
    Nov 2006
    Location
    Delton, Michigan
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    17,477
    well rob perhaps you could come to the us and get some treatment, us folks go over there for drugs???
    If in Doubt, Build it Stout!
    One hand washes the other!
    Don't put off today till tomorrow!

  4. #4
    Join Date
    Jul 2009
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    Amherst, New Hampshire
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    10,606
    Quote Originally Posted by larry merlau View Post
    well rob perhaps you could come to the us and get some treatment, us folks go over there for drugs???
    He better come before 10/1/13
    Faith, Hope & Charity

  5. #5
    Join Date
    Jul 2011
    Location
    The Gorge Area, Oregon
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    4,703
    Quote Originally Posted by larry merlau View Post
    well rob perhaps you could come to the us and get some treatment, us folks go over there for drugs???

    This may sound crazy but that's how my grandma got them to actually schedule her hip replacement. She told the doc in B.C. that she was scheduling the surgery in the states and lo and behold what was going to take 18-24 months to schedule was on the docket the next month.

  6. #6
    Join Date
    Jun 2008
    Location
    GTA Ontario Canada
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    12,264
    Someone definitely is watching over me, i got a real nice surprise last when my doc called me around 8:40 pm. He confirmed my thoughts but said he would make some calls and make it happen.

    I did find out something pretty interesting from him and that is once again politicians create issues that upset any system. Doc said due to a desire on the part of politicians to have metrics of measurement that would show the public wait times are coming down as a supposedly improvement of the system, the treatments that are listed in the "benchmark" wait times get priority and dealt with pretty fast, just to impress the voting public. But this means if you have something thats not on that hit list it takes a backseat. Artificial manipulation of the system to fool the public.

    Roger I respectfully disagree with you on your view that your operation or any health scheme anywhere in the world is "free" just because you did not take coin out of your pocket. In your case you have paid into a system through taxes for your entire life. Your operation was covered as a result, just the same way anyone buys insurance is covered. Hence the name OHIP (Ontario Health Insurance Plan) paid for through taxes not free.

    There is no reason to feel you cannot question or challenge or request improvement to a system simply because at one time or another you had a procedure that you could not have paid for yourself. That was the entire purpose and intent of having the system in the first place. Dont mean it cannot be improved. It also does not mean that should one find issue with the system that one needs to remain a silent humbled grateful citizen. I realize its not traditionally Canadian style to be confrontational but these issues need to be confronted in order to have them remedied. Paying a doctor peanuts and expecting him or her to continuously work long hours on top of it is not a sustainable formula for staff retention never mind attracting scarce human resources like specialist doctors.

    Here is the link to the benefits that you requested, there is nothing secret about this stuff its all there for public viewing if people would take the time to look it up and read it. The common thread i found in the bulletins that are sent out continuously is nothing but `This will result in an estimated saving of x million dollars`
    But there is no place i have found where this kind of rationalization and estimate is validated and proven. But it looks good to those only concerned with how much any specific item costs.

    http://www.health.gov.on.ca/english/...ysserv_mn.html
    cheers

  7. #7
    Join Date
    Aug 2008
    Location
    Reno, Nv
    Posts
    3,632
    After my surgery 2 years ago, I receiver the bill from just the hospital...not the doc's, pathology of anything else...just the hospital and keep in mind, I am an employee and had the employer offered insurance at the time. $114,537 for 7 days. After the adjusters finished hacking the charges, it came down to $53,000...We paid $600.
    I asked my Pulmonologist how this occurs; years ago a doc had a fixed cost of, let's say $20 for an xray and that's what they'd charge. Enter insurance companies. They say "Oh...we are only going to pay you $18 for the xray". ok...so doc raises his fee to $25, Insurance co says "Ok...we'll pay you $20". Then one day the insurance company says "Only paying you $15"...docs price goes up to $30. Insurance co..."OK...we'll pay you $25"...so now the doc is making a couple bucks, nothing wrong with that. So the moral of the story is that the more Medicare, Medicaid and insurance companies cut reimbursement...the more prices go up. This also explains why many MD's are closing the doors, 6300 in the last 12 months, 6 times the normal rate. Also keep in mind that a medical resident makes less than $10 an hour for 6 years and then good luck finding a job.
    Your Respiratory Therapist wears Combat boots

  8. #8
    Join Date
    Nov 2006
    Location
    Mountain Home, Arkansas
    Posts
    11,835
    Government involvement in health care is a touchy issue. Especially right now in America. And I do mean RIGHT NOW, this very minute in the U.S. No American should comment on your situation as we don't really understand the Canadian system or state of mind regarding the gub'mnt telling us how and what can can expect in the way of health care.
    I get Veteran's Administration health care. But I am at the lowest category. Right now I am waiting to be scheduled for a shoulder rotator cuff re-repair. But I have to wait for service connected injuries and retirees before they will even schedulde me. As I see it those are non-medical reasons and it should be first come first served. However, personally, I would readily step aside for a guy coming back from overseas with a war injury.
    "Folks is funny critters."

    Think for yourselves and let others enjoy the privilege to do so, too. ~Voltaire

  9. #9
    Join Date
    Feb 2012
    Location
    St. Catharines, Ontario, Canada
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    Rob, I don't disagree with anything you said in reply to me. Frank and others, what is the difference between the government running your health plan, and the corporations running your health plan and deciding what level of care you get? I'll tell you: the government runs a health plan with the objective of providing good health care to its citizens at a reasonable cost, the corporations run a health plan in order to make tons of money for themselved. Our employers pay the premiums in the form of a payroll tax; we used to pay a premium off our paycheques. OK, it isn't 'free' but it is universally accessible, and everyone gets the same, excellent health care.Your pollicy cannot expire, either. If you are one of the few residents of Ontario who has never bothered to pick up an OHIP card (there are some) you can walk into a Ministry of Health office and get registered as long as you can prove residency, and whether or not you have a pre-existing condition. Which of your corporate insurers can top that?
    Cheers,
    Roger


    The other member of Mensa, but not the NRA

    Everyone is a self-made person.

    "The thing about quotes on the internet is that you cannot confirm their veracity" -Abraham Lincoln

  10. #10
    Join Date
    Oct 2006
    Location
    somewhere east of Queen Creek, AZ - South East of Phoenix
    Posts
    8,529
    With all due respect to our family to the North who may not be aware we in the lower part of North America are in the throws of the new Health care reform as a matter of fact today is the first day for folks to sign up. It is a rather heated topic and I think in order to keep this within the TOC we need to tread lightly on the subject lest it become political. I happen to be a licensed agent and am ACA certified so if any members have question I invite you to either PM me or send me an E mail.
    "There’s a lot of work being done today that doesn’t have any soul in it. The technique may be the utmost perfection, yet it is lifeless. It doesn’t have a soul. I hope my furniture has a soul to it." - Sam Maloof
    The Pessimist complains about the wind; The Optimist expects it to change;The Realist adjusts the sails.~ William Arthur Ward

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