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 Sematic_Poise
Joined: 5/16/2008
Msg: 203
FREE Federalized Health CarePage 15 of 31    (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31)
Obama's health care idea is going to help the poor AND medium income people who really need it. Alot of the immigrants coming into this country need that help because they are poor when they get here and he's going to make sure everyone gets it that should.

Those rich people and the people making more than medium income can take care of themselves. They should also pitch in to pay for the rest of us cause they can afford it. Right?

I'm not sure what the dollar cut-off amount for covering "medium" income Americans -- but I'm sure it will be fair.

He promised coverage for medium income people. I'm sure I'll fall into that category cause I don't think I make that much. Woo Hoo!!!

I'm gonna love this "CHANGE"
 Montreal_Guy
Joined: 3/8/2004
Msg: 204
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History
FREE Federalized Health Care
Posted: 6/6/2008 4:18:59 AM

1) Canada is very upset about losing 10 percent of their medical school graduates. There is a doctor shortage in Canada.


That's only because they are sucked into the American system, driven by greed. Some people become doctors because they want to make sick people well, and others become one because they want to own a Ferrari. I've met both types.

In my job, doctors are the ONLY profession I've come across where even their WIVES address them as "Dr. X" when I call their houses on alarms. They identify THEMSELVES in the same manner, on a small (but regular) basis.

I had an experience where a man tried to push past me as I opened the door to my automatic teller machine, which is connected to a small local medical clinic.

He looked at me in a rather superior manner, and said " I'm Doctor X, and I need access to the clinic NOW."

I replied " I'm alarm operator Monty, and this isn't the door to the clinic, it's the door to my bank machine. Now move out of my way, because I was here first. "

These doctors take full advantage of our low cost medical universities, which provide them with a world class education - as many American medical students do, when they come here to study. Unlike those foreign medical students, they don't pay the full price.

They are subsidized in that education by taxpayers, the same ones they desert when they leave their country for higher salaries.

These are people that are already near the top of the income level in this country, with jobs promised for life if they are half way decent. Things like bank loans for houses and the like are zero problems for them.

Even so, some are dissatisfied, and leave their country for greener pastures.

When they get out of medical school, all to many do not want to work in areas outside of the major metropolitan ones - and those areas are not the ones that need the most doctors.

If you look at how much American doctors make, versus others worldwide, you'll see they are at the top of the graph - and yet American health statistics are many times much lower than those of other countries.

That's where the problems start with the US getting any sort of universal health care system realistically.
 flyonthewall!
Joined: 3/31/2008
Msg: 205
FREE Federalized Health Care
Posted: 6/6/2008 6:27:54 AM
steven02151--

Don't know why you refuse to actually go to Obama's site and look at his information on health care. It DOES NOT suggest extending Medicare. Here's the quote from his site:


Obama's Plan to Cover Uninsured Americans: Obama will make available a new national health plan to all Americans, including the self-employed and small businesses, to buy affordable health coverage that is similar to the plan available to members of Congress.


"Similar to the plan available to members of Congress" means the FEHBP. That's their health plan. I participated in FEHBP when I was a chief-of-staff on the Hill, 18 years ago.

MG--


That's only because they are sucked into the American system, driven by greed.


Oh for Pete's sake. The average family physician makes $75k a year in Canada. The gross is $150k, but once they pay their staff and office costs, that's what's left. Then they have to pay taxes off of that.

It's hardly GREED to go through 8 years of higher education and then 4 years of residencey (for family or internal medicine) and want to make more than the average factory worker. And while Canada has a shortage of doctors in ALL areas, it is family medicine that it has the worst problems. Specialties can still make a decent living up there.


They are subsidized in that education by taxpayers, the same ones they desert when they leave their country for higher salaries.


The average medical student in both the US AND Canada pays about 4% of the cost of their medical education (the extra fee for foreign students doesn't raise that significantly). Most of the fee is covered by university endowments. This is why some of the best endowed medical schools in the US are simply doing away with the tuition altogether.

Taxpayers DO NOT pay for medical education, or any other kind of education. What they do is shore up the tax base since colleges and universities are nonprofits, and therefore largely tax-exempt.

So if you think that the cost of a Canadian college education is servitude, then you need to extend that servitude to ANY person who graduates from a college and then leaves the country -- because it is all provided in a tax free environment.

Your characterization of doctors is ludicrous. Having been in health care legislation, health care lobbying, and health care writing my entire life, I know more doctors than you ever will. Doctors are like every other human being in the world, some are ***holes and some are so humble you would never know that they were doctors unless you came in the front door of their office. In fact, some of the best are some of the most humble.

Categorizing any group of human beings that way is the worst of sterotyping.


If you look at how much American doctors make, versus others worldwide, you'll see they are at the top of the graph


That's for doctors working in any version of NHS. However, almost every country outside of Canada (Korea and Cuba) has a second, private tier of medical care. Doctors go into private care because the conditions and the pay are superior. If you compared the compensation of private doctors to those in the US, I don't think you'd see much of a difference.
 Montreal_Guy
Joined: 3/8/2004
Msg: 206
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FREE Federalized Health Care
Posted: 6/6/2008 6:46:40 AM

Doctors in Canada make an average of $202,000 a year (2006, before expenses). Alberta has the highest average salary of around $230,000, while Quebec has the lowest average annual salary at $165,000, creating interprovincial competition for doctors and contributing to local shortages.

In 1991, the Ontario Medical Association agreed to become a province-wide closed shop, making the OMA union a monopoly. Critics argue that this measure has restricted the supply of doctors to guarantee its members' incomes.

According to a 2007 article, the Canadian medical profession is suffering from a brain drain. The article states, "One in nine trained-in-Canada doctors is practising medicine in the United States... If Canadian-educated doctors who were born in the U.S. are excluded, the number is one in 12."


So that "one in ten" brain drain includes "American" doctors educated here.

That salary average places them in the highest percentage of wage earners, and their jobs are promised for life - unlike any other professions. In today's world, that's a benefit that all other workers can never share with them. They also control access to that profession, and that's very much something "free and open markets" should concern themselves over.


Until recently, costs of medical education have been
very reasonable in Canada. However, since the early
1990s, tuition fees have risen, the costs of credentialing
and examinations have increased, malpractice insurance
and licensing fees have become higher, and obtaining an
appropriate residency training position has become
more costly. Although still moderate by US standards,
the debt loads of Canadian medical students at graduation
are now high (e.g., $38 000 on average among those
graduating from the University of Toronto).

http://www.cmaj.ca/cgi/reprint/158/8/1047.pdf



That debt is a joke, compared to what an American medical student graduates with.


6) All of this means that a 2003 graduate with $100,000 in debt who begins repayment after a three-year residency will generally pay $15,000 per year for 10 years. Consolidating the debt and extending repayment over a period of 25 years will result in payments of $12,000 per year for a quarter-century. In 2003, the consolidated interest rate for Stafford loans was only 2.82 percent. When interest rates reach the maximum allowable rate of 8.25 percent, as they have been known to do, or when students need to borrow additional money from private sources, repayments can well exceed these estimates.

http://scienceweek.com/2005/sa050304-6.htm


What that does is drive doctors salaries higher, as they struggle to pay off a debt that continues for years.

I'd suggest a free education, for those with enough talent to justify it based on marks and performance in medical school, along with a pledge to work in areas where doctors are most needed for a certain number of years.

I'd also charge any new doctor who was Canadian born for the difference for that subsidized education, if they leave the country within a few years of graduating, simply for more money.

I'd exempt anyone going there to learn more in a specific area of study, like ER work,where it could be proven there was more chance of learning there based on caseloads.

I'd also use Canadian military helicopters and military emergency medical air crews to offer "lifeflight" type services in metropolitan areas. This would provide good training in real life situations, like landings and takeoffs in all sorts of weather in cities.

This would assist all sides, and provide a service we need.

Of course, we need more choppers first.......
 flyonthewall!
Joined: 3/31/2008
Msg: 207
FREE Federalized Health Care
Posted: 6/6/2008 7:42:35 AM
MG --

The average doctor pay you describe is for ALL specialties and BEFORE they pay for their offices and office workers. Even a modest office costs $75k per year after you've paid a nurse to assist you.

Family doctors make less than all the other specialties, which is why you have trouble keeping them in Canada. By the time they've paid their office expenses there's not that much for them to live off of.

Doctors anywhere have a job for life because the profession is needed. But you can say this about nurses, teachers and a lot of other professions. It's not because the state guarantees their jobs. Canadian doctors aren't paid by the government, they are in private practice just as they are in the United States.

However, they are required to accept provincial health insurance reimbursement as payment which is what keeps their earnings very low compared to the US.

This is not so much of a problem in the specialties, but it is in family practice.

As far as the debt of American medical students goes, it depends on where you go to medical school. There are some very reasonably priced medical schools in the United States and also some that have now done away with tuition. I think the trend will be towards lower medical school tuition and free tuition in schools that have high endowments. So in the future, American medical students are likely to have LESS debt than their Canadian counterparts.

If you are going to penalize doctors who get medical education in Canada, then you need to penalize ANY CANADIAN who gets a higher education in Canada and then leaves the country to work elsewhere. Otherwise you're making doctors a special class. In the US this would be considered unconstitutional, and it would probably also be considered unconstitutional in Canada.
 flyonthewall!
Joined: 3/31/2008
Msg: 208
FREE Federalized Health Care
Posted: 6/6/2008 1:25:36 PM
Neither Obama nor Clinton were suggesting a health care plan paid for by tax-payer dollars EXCEPT for people who are already poor and qualify for Medicaid, or are over 65 and qualify for Medicare.

In both the health care plans (although I guess only Obama's counts now) the subscriber would need to pay for the insurance. The only difference is that group health plans like FEHBP have group rates and no preexisting illness clauses. That makes the insurance more affordable, and also allows people with chronic illnesses to get coverage without exclusions.

There is no plan to PAY for the health care, except in the instance of the poor, and those people already qualify for Medicaid.

BTW, I've never quoted John McDonough. You must be confusing me with someone else.
 Montreal_Guy
Joined: 3/8/2004
Msg: 209
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History
FREE Federalized Health Care
Posted: 6/6/2008 1:50:30 PM

The average doctor pay you describe is for ALL specialties and BEFORE they pay for their offices and office workers. Even a modest office costs $75k per year after you've paid a nurse to assist you.

Family doctors make less than all the other specialties, which is why you have trouble keeping them in Canada. By the time they've paid their office expenses there's not that much for them to live off of.


Yeah, right.

I protect many doctors, and believe me - they are not in any serious financial trouble up here. Family doctors, here and there, also have a free ride paid by big pharma. They get the same perks, travel paid, and money for pushing the right type of pills any chance they get.


Doctors anywhere have a job for life because the profession is needed. But you can say this about nurses, teachers and a lot of other professions. It's not because the state guarantees their jobs. Canadian doctors aren't paid by the government, they are in private practice just as they are in the United States.


Wrong again. Teachers CAN (and do) get laid off, or have a hard time finding a well paying job.

As for your " private practice" comment :


Under the terms of the Canada Health Act, all "insured persons" (basically, legal residents of Canada, including permanent residents) are entitled to receive "insured services" without co-pays. Such services are defined as medically necessary services if provided in hospital, or by 'practitioners' (usually physicians).[1]. Approximately 70% of Canadian health expenditures come from public sources, with the rest paid privately (both through private insurance, and through out-of-pocket payments). The extent of public financing varies considerably across services. For example, approximately 99% of physician services, and 90% of hospital care, are paid by publicly funded sources, whereas almost all dental care is paid for privately.

http://en.wikipedia.org/wiki/Medicare_(Canada)



However, they are required to accept provincial health insurance reimbursement as payment which is what keeps their earnings very low compared to the US.


Wrong, as shown above.


As far as the debt of American medical students goes, it depends on where you go to medical school. There are some very reasonably priced medical schools in the United States and also some that have now done away with tuition. I think the trend will be towards lower medical school tuition and free tuition in schools that have high endowments. So in the future, American medical students are likely to have LESS debt than their Canadian counterparts.


I'd like to see this backed up with a citation, please.


If you are going to penalize doctors who get medical education in Canada, then you need to penalize ANY CANADIAN who gets a higher education in Canada and then leaves the country to work elsewhere. Otherwise you're making doctors a special class. In the US this would be considered unconstitutional, and it would probably also be considered unconstitutional in Canada.


Doctors are different because they are paid through the public purse, and financed by the public purse with low cost subsidized education. Their profession also demands that they help where help is needed, by oath.

They are a critical part of the fabric of society, and enjoy great benefits from that profession.


You must be confusing me with someone else.


Well you DO so remind me of another former poster here. I figure in this pond there can't be too many people that know McCain personally.

I do know of one other poster that claimed that very special distinction, the same one you do, and they don't post here anymore.

Hmmmm......
 flyonthewall!
Joined: 3/31/2008
Msg: 210
FREE Federalized Health Care
Posted: 6/6/2008 7:38:15 PM

I protect many doctors,


Doctors in Canada need body guards?


Approximately 70% of Canadian health expenditures come from public sources, with the rest paid privately (both through private insurance, and through out-of-pocket payments). The extent of public financing varies considerably across services. For example, approximately 99% of physician services, and 90% of hospital care, are paid by publicly funded sources, whereas almost all dental care is paid for privately. . . .

Wrong, as shown above.


Uh, no. The 70 percent means that about 30 percent of health care in Canada isn't paid by your insurance AT ALL. These are things like dental, private nurses, private rooms. If you want those things you either need to pay for them out of pocket, or get insurance for those non covered services.

However, those services that are covered, are covered 100 percent. Doctors, hospitals, etc. are not allowed to charge more for those covered services.


I'd like to see this backed up with a citation, please.


Here are a few articles for you:

Harvard Medical School to lower tuition
http://www.boston.com/news/local/articles/2008/03/22/harvard_medical_school_to_lower_tuition/

Cleveland Clinic Medical School To Offer No-Cost Education For Students Pursuing Academic Careers

http://www.medicalnewstoday.com/articles/107861.php

No change in store for med school aid
http://daily.stanford.edu/article/2008/5/5/noChangeInStoreForMedSchoolAid


Changes are afoot for Stanford’s rival medical schools. In March, the Dean of Harvard Medical School announced that the school will no longer require a family contribution from students whose parents earn less than $120,00 per year. Three weeks later, the Yale School of Medicine announced that it would eliminate the required family contribution for households earning less than $100,000 annually. The changes for both schools will begin next year.


I can find more for you if you'd like.




Doctors are different because they are paid through the public purse, and financed by the public purse with low cost subsidized education. Their profession also demands that they help where help is needed, by oath.


No. ALL people who go to colleges which get a tax exemption are financed indirectly by the public. Doesn't matter whether it's medical school, nursing school, law school or an undergraduate education.


Well you DO so remind me of another former poster here. I figure in this pond there can't be too many people that know McCain personally.


Can't help you there. I've never been here under another name.

However, it's not terribly hard to know McCain personally. All you have to do is have worked on the Hill to do that. And I was a senior legislative aid on the Senate side for over 10 years. I also have a circle of friends that keep me in touch with him, FWIW.
 designingwoman
Joined: 9/4/2005
Msg: 211
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FREE Federalized Health Care
Posted: 6/7/2008 5:50:57 PM
I want to bring up a point that was made in the local newspaper: Women are losing health insurance coverage because they've had C-sections when they had their babies. This kind of insanity must stop. I am eagerly awaiting the day I can sign up for Medicare and say "f off" to the private health insurance industry for doing this and many other things that result in people dying and going medically bankrupt.
 Montreal_Guy
Joined: 3/8/2004
Msg: 212
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FREE Federalized Health Care
Posted: 6/8/2008 5:07:45 AM
Doctors are different because they are paid through the public purse, and financed by the public purse with low cost subsidized education. Their profession also demands that they help where help is needed, by oath.


No. ALL people who go to colleges which get a tax exemption are financed indirectly by the public. Doesn't matter whether it's medical school, nursing school, law school or an undergraduate education.


The difference is that medical care specialists have an important function that those others do not - at least in the same measurement.

They are there to relieve physical suffering, and prevent death. That's something that should not be dependent on your wallet. People who do not get adequate health care suffer and die, and possibly infect others.

So their place in society is MUCH different than those others you bring forward as examples.

As for tuition costs ?

So ? Big deal. Their families don't have to pay a bribe to get their kids into those universities.

What's the tuition there ?


Costs

Harvard Medical School tuition rates are reset annually and cover courses taken from August 1 through June 30 each year up to the final year of enrollment ending with graduation. Tuition is billed by semester. Two forms of term bill payment are available: payment in full by semester or monthly payments (payments for the year are spread over eight months). The monthly payment plan carries a service charge of $35 per semester.

An estimate of yearly expenses shows that the average cost for an unmarried first-year student will be approximately $60,880 for the 10.5-month academic year 2007-2008. This estimate includes tuition, health service fee and insurance premium, room and board, books, travel, transportation to clinical sites, laundry, and incidentals. Students whose homes are outside the northeast region of the United States may experience travel costs beyond the scope of this estimate.

Students who opt for the 5-year program or whose time for meeting degree requirements at Harvard Medical School exceeds eight semesters and who have paid eight semesters of full tuition will be assessed a reduced tuition charge for each semester of enrollment beyond the eighth. This reduced tuition is expected to be $1,100 per semester in 2007-2008.

Tuition and Fees for a First Year Student are as follows:

2007-2008
Tuition $38,600

Univ. Health
Services Fee $1,426

Blue Cross /Blue Shield $1,362

Disability Insurance$63

Matriculation Fee $35

Educational Materials Fee $375

Vanderbilt Hall (avg. rent$7,100)

http://hms.harvard.edu/admissions/default.asp?page=costs


That's from Harvard's OWN site, btw.

So you are looking at something like a MINIMUM 40 grand a year - each year you are there.

Canadian medical student's cost ?

http://www.cmaj.ca/cgi/reprint/158/8/1047.pdf

At McGill, in Montreal, it's something like 2 grand a year (roughly) for tuition.


Although still moderate by US standards,
the debt loads of Canadian medical students at graduation
are now high (e.g., $38 000 on average among those
graduating from the University of Toronto)

- Ibid


The quality of the teaching staff there is world class, and also heavily subsidized by taxpayers like myself.

A GRADUATE of a Canadian , top level, medical school pays a total of what an American FIRST year student has to pay.

That's one heck of a difference.


Can't help you there. I've never been here under another name.

However, it's not terribly hard to know McCain personally. All you have to do is have worked on the Hill to do that. And I was a senior legislative aid on the Senate side for over 10 years. I also have a circle of friends that keep me in touch with him, FWIW.


Well, sorry for the confusion then.

You'll have to excuse the comparison, because there were some remarkable coincidences there to be seen.

- same sex
- same hair color
- both Caucasian
- roughly the same age
- no children for both
- non-religious for both
- same high level of education
- last post for the former on 1/15/2008
- join date for the latter - 3/31/08
- same concentration on health threads
- Both Geminis
- same writing style ( this is an opinion, based on a study of both writer's posts )
- both know McCain personally

So you will have to forgive my suspicions, based on all these remarkable coincidences between two totally different people.

Now this is not an off topic point, btw.

My worry was that if you were indeed the same person, then you were concealing the fact that you were a lobbyist in the past , and a medical publisher now.

Now, when posting on a topic like health care , that's something that may in fact color one's posts based on profession and lobbying experience. That doesn't invalidate it, in any way, but it's something that the reader should be aware of if they think someone is posting from an unbiased personal opinion.

So thanks for clearing that one up for me, FWIW.
 flyonthewall!
Joined: 3/31/2008
Msg: 213
FREE Federalized Health Care
Posted: 6/8/2008 6:50:15 AM
MG -- All I can say is you have way too much time on your hands. I don't know whose profile you're looking at, and I don't really care to know. There are a lot of women who would match the description above who also have master's degrees (I have two, FWIW).

Further, people of all persuasions and occupations post in these forums. Some reveal their occupations and some don't. Finally there is no such thing as an unbiased personal opinion. I'm sure that your socialist views are based on your life experience, much like my free market views are based on mine. You take this all way too seriously. POF is a forum for the entertainment purposes of the people here, we aren't curing cancer.

As far as Harvard goes, you are posting last year's tuition rates. Next year tution will be $12,500 for all students whose parents make less than $120,000 per year. There are other schools which are also offering free or low cost tuition, and some schools that have always had tution comparable to or less than Canadian schools. And, FWIW, Ontario medical schools have had spiriling tuition costs over the last few years. Base tution (before fees) is almost $17,000 at the University of Toronto. Base tution is $11,000 at McGill (not $2,000) unless you are a resident of Quebec --then it is $3,700.

The figures above are a couple of years old, so the tution is probably higher now:

http://www.edmontonsun.com/News/Canada/2008/06/04/5767546.html

Fact is that medical school tution is being reduced in many of the most prestigious universities in the US because they can afford to do so. It's a trend that we will see increasing over the years to come.

You make it sound like doctors are some kind of slaves that must perform regardless of whether they get paid or not. Medicine is a profession, no different than law, teaching, police work or accounting. Unless you want to change the laws to take away the civil rights of doctors, they can practice where they want, in the specialties they want, or they could decide they don't like medicine after all and go live in an ashram.

In many professions schools make offers to doctors, teachers and other needed professions to pay for tuition if they agree to work in underserved areas for a number of years. In the US some students pay for high medical school tuition costs by joining the Public Health Service, which does something similar. So in those instances there is a requirement for them to work in those areas until the obligation is fulfilled.

My opinion is that if you tried to legislate away the freedom of doctors to practice where they want, and in the specialties they want, Canada would have an even worse doctor crisis than it has now because no one would want to join the profession.
 flyonthewall!
Joined: 3/31/2008
Msg: 214
FREE Federalized Health Care
Posted: 6/9/2008 4:57:41 AM
^ ^ ^ ^ Honestly, if you're going to jump in and comment to a post that wasn't directed at you, you should try reading BOTH messages.

I wasn't suggesting that doctors were at this time being restricted as to where and what they practiced, I was responding to MG's message 747. Try READING it.

American's don't "cherry pick" Canadian doctors. The doctors come here because they want to be able to make a decent living. Even though medical school tuition is less in Canada than it is in the United States, a physician can still have considerable debts when he or she graduates. Add a family to that and coming to the United States isn't just an option, it's a necessity. Double that for any physician practicing family medicine -- a much needed profession, but one that isn't as well paid as other specialties.

You confuse "chasing the almighty dollar" with being able to make a good living. A doctor should not have to live on $75k before taxes, after he/she has paid for office expenses. But that is the average family doctor's net in Canada.

The US DOES NOT have an excess of doctors. We only have slightly more nationwide, but that difference is enough to avoid doctor shortages for the most part.

As far as the private clinics in Canada go, the numbers are increasing every year. The wealthy don't want to have to travel to the US or overseas to avoid waiting months, or sometimes a year or two for needed treatment. Now they are able to bypass waiting lines for certain procedures, like joint replacement. They are also able to join family practice partnerships for several thousand dollars a year, so that they have a family doctor. These are in short supply in many provinces, and in some areas there are none available, because the few family doctors already have full patient loads.

The thousand or so private clinics across Canada hardly need "national public marketing" to get enough patients. Patients are waiting at the doors to join. The only reason a physician would advertise is if they needed to entice new patients into the practice.

The handwriting is on the wall. In years to come Canada will have a tiered system just like the UK, and most other nations with universal care. It may be coming at a very slow pace, but it is coming.

The provincial insurance programs across Canada are at the verge of collapse, they can't raise enough money through taxes to pay for the health care needs of an aging population, and without private services that collapse will occur sooner. This is precisely why the government turns a blind eye to many of the clinics that operate in violation of local laws. The baby boomers are getting older, with the oldest of them now at retirement age. With a huge population of ageing people, and not as many young taxpayers to support them, all tax based programs worldwide will begin seeing the stress.

Since Canada's UHC is tax based, it's going to feel the pain sooner than later.
 Montreal_Guy
Joined: 3/8/2004
Msg: 215
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History
FREE Federalized Health Care
Posted: 6/9/2008 5:15:52 PM

As far as Harvard goes, you are posting last year's tuition rates. Next year tution will be $12,500 for all students whose parents make less than $120,000 per year. There are other schools which are also offering free or low cost tuition, and some schools that have always had tution comparable to or less than Canadian schools. And, FWIW, Ontario medical schools have had spiriling tuition costs over the last few years. Base tution (before fees) is almost $17,000 at the University of Toronto. Base tution is $11,000 at McGill (not $2,000) unless you are a resident of Quebec --then it is $3,700.


Let's review....


Harvard offers discount on med school tuition

Eligible students could save up to $12,500 a year.

Lana Lobachova expects to be more than $100,000 in debt when she graduates from Harvard Medical School two years from now. But that amount should shrink under Harvard's plan to boost its financial aid package for some medical students by as much as $50,000 over four years.

In March, Harvard announced that students whose families earn $120,000 or less a year will get up to $12,500 off the annual $65,000 cost of tuition and living expenses. The program will start with the 2008-09 academic year.

Harvard now offers $24,500 in subsidized federal and institutional loans to students who demonstrate financial need. Students whose families make $120,000 or less must contribute about $12,500 before being considered for an institutional scholarship.

Under the new plan, the Boston school would cover the $12,500 family contribution by increasing its institutional scholarships to $11 million annually. Of the school's 700 students, 235 would be eligible for the funds, to be distributed based on a school formula.

"I haven't worked it out yet, but I hope I will save a large amount," said Lobachova, who qualifies for aid.

Jeffrey Flier, MD, Harvard Medical School dean, said it is important for the school to ease students' debt, which averages $98,000 at Harvard, so graduates will be able to pick a specialty regardless of its income.

The median medical school debt is $140,000, according to the Assn. of American Medical Colleges. Today's graduates pay 9% to 12% of their income toward school loans, a figure that could grow to 25% to 31% of doctors' income by 2033, the AAMC said.

http://www.ama-assn.org/amednews/2008/05/12/prsb0512.htm


Only one third of students qualify.

From the New England Journal Of Medicine :


With Debt on the Rise, Students and Schools Face an Uphill Battle

Mar.–Apr. 2008

Medical student debt is threatening to become untenable for young physicians. Medical school graduates in 2006 found they owed about $130,000 on average when their educational bills came due. This figure is daunting even for those earning the estimated mean physician income of $216,000, and it can take years for younger doctors to reach that income level. Many primary care physicians may never reach it, as they earn an average of about 30 percent less than the mean.
Indebtedness Rates Growing for Both Public and Private Medical Schools: The Impact of the Physician Workforce Shortage

A 2004 AAMC report on student debt and education costs, updated last fall, indicated that indebtedness rates are growing at an average of 6.9 percent for public medical school graduates and 5.9 percent for their private school counterparts. The 2004 report projected annual growth of owed monies at 8.3 percent and 8.9 percent for public and private schools, respectively. The good news is that these rates were lower than anticipated, but the bad news is that these increases still far outpace the estimated 3 percent annual increase in physician income.

In a worst-case scenario, the 2007 report update estimated that in 2033, physicians who opt for the standard 10-year loan repayment plan would see half of their after-tax earnings going to loan repayment. This could deter promising students from considering medical school, especially those with lower-income backgrounds.

“In the long run, schools will have a hard time filling their classes with good students if graduates can’t repay their debts without undue hardship,” said AAMC Senior Associate Vice President H. Paul Jolly, Ph.D., who led the study. “Right now, people with parental incomes in the top 20 percent of U.S. families are making up 55 percent of medical school students. If present trends continue, this imbalance will only worsen.”

The report found more sobering news for students who hope to gain a financial advantage by matriculating to medical schools in their home state. With public medical school tuition and debt catching up with the private schools, qualified students may no longer benefit from less expensive in-state tuition that these public schools traditionally have offered. According to the AAMC report, if present trends continue, by 2033, the average debt of public and private medical school graduates would be nearly identical.

Many in the academic medical community worry that rising debts will not only discourage students from considering medicine, but will take – or is already taking – a serious toll on the existing physician workforce. As evidenced by Knight, it is increasingly difficult to recruit young physician researchers because the field offers comparatively low income. Projected shortages in the lower paying primary care specialties can have an immediate impact on the nation’s health care system.

“Primary care physicians are the usual first stop for a person with a new illness or minor injury,” Jolly said. “If a shortage of these doctors should develop, the remaining primary care physicians would be stressed, and new patients would have difficulty being seen promptly.”
Medical Schools Develop Expense/Debt Management Strategies for Students

But with all of these threats in mind, some in the medical education community are taking action. Many medical schools are developing expense management strategies for their students, or educating medical students on the essentials of financing their education.

Some are even reviewing their payment mechanisms to help bring down expenses. The University of Minnesota Medical School, the Mayo Clinic College of Medicine, and Washington University in St. Louis School of Medicine have instituted policies through which tuition for new students does not rise during their medical school tenure. The policy helped Minnesota end its reign as the public medical school with the nation’s highest average tuition.

“We implemented this policy because at that time our school had the highest tuition,” said Deborah E. Powell, M.D., medical school dean at Minnesota. “We wanted to see if we could change that. Students like the predictable nature of this policy. It allows them to plan better.”

The program, which began four years ago, now allows students up to six years to graduate at the frozen tuition cost, on the provision that they are using any time away from school to participate in activities related to medical education. Since this policy was started, Powell said she has seen Minnesota’s ranking fall from the most expensive to second-most expensive public medical school, and hopes this modest trend continues.

Robert McCormack, assistant dean of student affairs and director of financial aid at Washington University’s medical school, said that his institution’s fixed tuition policy “enables our students to budget for their entire education. That was the genesis behind it, and we think it’s a great asset for students.” McCormack estimated that the freeze has kept average medical student debts at about $98,000, or more than $30,000 under the national mean.

Yale University School of Medicine’s Director of Financial Aid Pamela Nyiri said her school has purposely established a low threshold for their students’ base loan, which is the basis upon which loan payments are set.

“We are very committed to keeping the base loan as low as possible, so that debts are as low as possible and we can free students not to make career decisions based on money,” Nyiri said.

The lender community discourages over-borrowing, but said that being somewhat in the red is not always reason to panic.

“Our view is that students should borrow only what they need, and that a certain amount of debt is not a bad thing, especially on a very, very good investment like medical school,” said Timothy M. Fitzgibbon, vice president of debt management services at the National Council of Higher Education Loan Programs, a national organization that represents guaranty agencies, secondary markets, lenders, and other related groups.

The AAMC is unveiling a new educational program to help financial aid officers and students navigate the complexities of medical school debt and understand repayment options. With the association unlinking itself from any direct engagement with a commercial lender (i.e., ending its long-term engagement with Sallie Mae in the AAMC MEDLOANS program), AAMC officials said the association is well positioned to offer constituents a comprehensive tool to educate students on debt management.

The first phase, scheduled to launch May 1, will provide the program’s logistical groundwork. Future phases will include highly interactive tools and resources that will assist financial aid administrators and students in evaluating individual loan programs and help the latter group develop good consumer practices, financial literacy, and responsible repayment behavior.

“The idea is to provide unbiased information, resources, and tools to support the efforts of our financial aid constituency and help students make informed decisions,” said Julie Fresne, director of student financial services at the AAMC. “We envision a comprehensive program that includes, among other things, an online mechanism that can compare and evaluate loan terms and conditions.”

Of course, there is no magic bullet to solve the student debt equation. “Debt is a multifaceted issue, and we need to focus our energy and best efforts into addressing it,” Fresne said.

Source: AAMC Reporter: January 2008 — By Elissa Fuchs


http://www.nejmjobs.org/rpt/Medical_School_Debt_Rising.aspx


The NEJM is certainly a valid citation, and it's saying the same thing I am. Even within the industry, doctors are feeling enormous pressure carrying that debt load - as proven my the NEJM's own report. They pass that on to clients, just one part of the process that leads to higher medical costs.

You are correct on Canadian tuition fees at those two universities. The important fact to note, as I said, was that (for Quebec residents) $ 3,700 dollars/year is a remarkably low tuition for a world class university medical education.

As I stated, this is a taxpayer subsidized education, at that level.

Look at Quebec's tax laws concerning this :


Stipend
Money paid to a graduate student from a grant for the student to work on their thesis research which is part of the research program of the professor's grant. This is an amount of money paid annually to the student. This source of money is treated as a scholarship for income tax purposes, i.e. currently exempt from Québec income tax and allowing either a complete or partial exemption from federal income tax. For federal income tax purposes, registered students and postdocs who receive a T2202 or T2202A are eligible for the education amount and thus completely exempt from income tax on their scholarship income, while those without a T2202 or T2202A receive a partial exemption only. A stipend can be paid to international students as well as Canadian nationals. In Quebec, postdocs are considered supervised research trainees, not salaried employees. The federal and Quebec granting councils allow postdocs to be paid in the form of a stipend from research grants, which is treated as a scholarship for income tax , i.e. currently exempt from Québec income tax and either totally or partially from federal income tax (since the 2006 federal budget,
scholarship income is totally exempt from federal income tax if the awardees is entitled to the education amount, as evidenced by a T2202 or T2202A). Where allowed by a granting agency, postdocs should be paid in the form of a stipend. Only in cases where an agency only allows payment in the form of a salary should this form of payment be used. Foreign postdocs paid in the form of a salary may be entitled to a partial deduction for Quebec income tax purposes, if they meet the requirements for the “Certificat d’admissibilité” issued by the Quebec Government

(see http://upload.mcgill.ca/gps/pdinfo.pdf for details and links).



Tuition fees
Tuition fees paid during medical school or a residency program are not deductible but may be eligible for the "tuition tax credit". Obtain Form T2202A from your university to determine allowable tuition costs. Keep in mind that fees paid for admission, application, use of library or laboratory facilities, examinations (including re-reading) and diplomas, as well as mandatory computer service fees and certain academic fees qualify as eligible tuition fees. Other tuition fees (i.e., for ATLS courses, certain LMCC preparation courses) may also qualify for the tax credit. Contact the course administrators for further details and be sure to obtain appropriate documentation for these courses from them.
In addition to the tuition tax credit, students may also claim an education tax credit. Although full-time medical students can generally claim a Federal education tax credit of $400 per month ($120 per month for part-time students), this benefit has not always been available for residents who were considered to be pursuing post-secondary education in relation to their current employment. The March 23, 2004 federal Budget removed this employment restriction, so those residents in an otherwise qualifying educational program may be eligible for the education tax credit for the 2004
and subsequent taxation years, provided that no part of the education cost is borne by or reimbursed by their employer. Consult your provincial house organization (e.g., PAR-A, PARI-MP, PAR-O, etc.) or tax advisor for more details.

Should a medical student not be required to use their entire tuition/education credit to reduce their tax to nil, these remaining credits may be transferred to an eligible person (e.g., spouse or common-law partner or, under certain restrictions, a parent or grandparent) up to a maximum of $5,000. For 2007, this translates to a $750 federal tax credit. To make this designation, the student must complete and sign Form T2202A. A copy of the signed form should be kept by the designated person and, if applicable, by the student to support the amount claimed. The form does not need to be filed with the
return but must be available if requested by the CRA. Students are entitled to carry forward indefinitely unused tuition and education tax credits. This will
enable students to utilize the credit when they have sufficient income (i.e., during residency). Any amount not used in the current year by the student and not transferred to an eligible person will be automatically available to carry forward. However, once income is sufficient to utilize the unused taxcredits, they must be applied to reduce taxes payable.

www.mcgill.ca/gps/postdoc/einfo/tax/


So you can see , quite clearly, that the tax structure is quite forgiving for medical students here, and that cost does prove that society is contributing to reducing their education costs in a very direct way, and a large one.

That said, as I previously stated, when one graduates (after receiving this benefit from society all through your education) your costs have been substantially reduced by society.

To turn around then, and leave simply for a higher salary outside Canada - is outrageous.
In effect, you've turned your back on the society that's allowed you great freedom in beeoming a doctor.


Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care, The Commonwealth Fund, May 2007, by K. Davis, C. Schoen, S. C. Schoenbaum, M. M. Doty, A. L. Holmgren, J. L. Kriss, and K. K. Shea: Overview Despite having the most costly health system in the world, the United States consistently underperforms on most dimensions of performance, relative to other countries. This report—an update to two earlier editions—includes data from surveys of patients, as well as information from primary care physicians about their medical practices and views of their countries' health systems. Compared with five other nations—Australia, Canada, Germany, New Zealand, the United Kingdom—the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. The U.S. is the only country in the study without universal health insurance coverage, partly accounting for its poor performance on access, equity, and health outcomes. The inclusion of physician survey data also shows the U.S. lagging in adoption of information technology and use of nurses to improve care coordination for the chronically ill.

Executive Summary
The U.S. health system is the most expensive in the world, but comparative analyses consistently show the United States underperforms relative to other countries on most dimensions of performance. This report, which includes information from primary care physicians about their medical practices and views of their countries' health systems, confirms the patient survey findings discussed in previous editions of Mirror, Mirror. It also includes information on health care outcomes that were featured in the U.S. health system scorecard issued by the Commonwealth Fund Commission on a High Performance Health System.

Among the six nations studied—Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2006 and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last on dimensions of access, patient safety, efficiency, and equity. The 2007 edition includes data from the six countries and incorporates patients' and physicians' survey results on care experiences and ratings on various dimensions of care.

Key Findings

Quality: The indicators of quality were grouped into four categories: right (or effective) care, safe care, coordinated care, and patient-centered care. Compared with the other five countries, the U.S. fares best on provision and receipt of preventive care, a dimension of "right care." However, its low scores on chronic care management and safe, coordinated, and patient-centered care pull its overall quality score down. Other countries are further along than the U.S. in using information technology and a team approach to manage chronic conditions and coordinate care. Information systems in countries like Germany, New Zealand, and the U.K. enhance the ability of physicians to identify and monitor patients with chronic conditions. Such systems also make it easy for physicians to print out medication lists, including those prescribed by other physicians. Nurses help patients manage their chronic diseases, with those services financed by governmental programs.

Access: Not surprising—given the absence of universal coverage—people in the U.S. go without needed health care because of cost more often than people do in the other countries. Americans were the most likely to say they had access problems related to cost, but if insured, patients in the U.S. have rapid access to specialized health care services. In other countries, like the U.K and Canada, patients have little to no financial burden, but experience long wait times for such specialized services. The U.S. and Canada rank lowest on the prompt accessibility of appointments with physicians, with patients more likely to report waiting six or more days for an appointment when needing care. Germany scores well on patients' perceptions of access to care on nights and weekends and on the ability of primary care practices to make arrangements for patients to receive care when the office is closed. Overall, Germany ranks first on access.

Efficiency: On indicators of efficiency, the U.S. ranks last among the six countries, with the U.K. and New Zealand ranking first and second, respectively. The U.S. has poor performance on measures of national health expenditures and administrative costs as well as on measures of the use of information technology and multidisciplinary teams. Also, of sicker respondents who visited the emergency room, those in Germany and New Zealand are less likely to have done so for a condition that could have been treated by a regular doctor, had one been available.

Equity: The U.S. ranks a clear last on all measures of equity. Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick, not getting a recommended test, treatment or follow-up care, not filling a prescription, or not seeing a dentist when needed because of costs. On each of these indicators, more than two-fifths of lower-income adults in the U.S. said they went without needed care because of costs in the past year.

Healthy lives: The U.S. ranks last overall with poor scores on all three indicators of healthy lives. The U.S. and U.K. had much higher death rates in 1998 from conditions amenable to medical care—with rates 25 to 50 percent higher than Canada and Australia. Overall, Australia ranks highest on healthy lives, scoring first or second on all of the indicators.

Summary and Implications
Findings in this report confirm many of the findings from the earlier two editions of Mirror, Mirror. The U.S. ranks last of six nations overall. As in the earlier editions, the U.S. ranks last on indicators of patient safety, efficiency, and equity. New Zealand, Australia, and the U.K. continue to demonstrate superior performance, with Germany joining their ranks of top performers. The U.S. is first on preventive care, and second only to Germany on waiting times for specialist care and non-emergency surgical care, but weak on access to needed services and ability to obtain prompt attention from physicians.

While many U.S. hospitals and health systems are dedicated to improving the process of care to achieve better safety and quality, the U.S. can also learn from innovations in other countries—including public reporting of quality data, payment systems that reward high-quality care, and a team approach to management of chronic conditions. Based on these patient and physician reports, the U.S. could improve the delivery, coordination, and equity of the health care system by drawing from best practices both within the U.S. and around the world.


http://economistsview.typepad.com/economistsview/2007/05/an_internationa.html


http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=482678

For the most money spent, America's medical system overall gives far less care than most other Western industrial nations to the general population . The statistics back that up, if you want to look at them.

I agree with fireknight, health care should not be considered a profit center - but a basic right to be supplied to the population. One's health and well being should not be determined by one's wallet.
 designingwoman
Joined: 9/4/2005
Msg: 216
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Posted: 6/9/2008 7:13:24 PM
Yes, and the greed of private health insurance companies and pharmaceutical companies. We need to get health care out of the grip of the greedy private insurance companies. Enough already! I know I am quite fed up with private insurance and the day I can get government health care is one day I am going to celebrate!! I can't wait to set up the keg and grill

Cheers to steven and fireknight for excellent posts. Thank you!!!
 flyonthewall!
Joined: 3/31/2008
Msg: 217
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Posted: 6/10/2008 10:14:19 AM
In March, Harvard announced that students whose families earn $120,000 or less a year will get up to $12,500 off the annual $65,000 cost of tuition and living expenses. The program will start with the 2008-09 academic year.


You are right, it was the discount that is $12,500, but you are also comparing apples and oranges here. The full tuition charge for Harvard is $38,000, which would leave the yearly tuition at $25,500.

Even students in Canada have to pay for living expenses which were not calculated in my post above.

And if only a third of Harvard Medical School students come from families that make $120K and less, then the majority students are coming from families in the top 10 percent of wage earners in this country. They can afford to pay a little more tuition (and before you make the multiple student argument, that is always considered when giving aid).

Further, if you go to a state school (and you reside in state) you can save a lot of money in tuition. For example, Baylor Medical School in Texas (a top ranking school) charged $6,550 for tution for 2007-2008 and $19,650 for out of state (still not a bad deal).

http://grad-schools.usnews.rankingsandreviews.com/grad/mdr/items/04110

You can go to the University of Texas Southwestern Medical Center--Dallas for $11,212 in-state and $24,312 out of state:

http://grad-schools.usnews.rankingsandreviews.com/grad/mdr/items/04116

There are many other medical schools with rates that are quite reasonable. You just have to know where to apply.
 Montreal_Guy
Joined: 3/8/2004
Msg: 218
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Posted: 6/10/2008 10:18:17 AM
And, as I posted , the tax laws here heavily subsidize medical students.

That's a gift from the taxpayer, that reduces their total expenditures in a VERY real sense.

Even a bone fide medical journal from the USA is saying EXACTLY what I said, in regards to the heavy burdens that doctors starting their career face.


At the end of their education here, those students (at least in my view) have a duty as health care professionals to assist those who assisted them - as well as an oath to heal the sick.
 flyonthewall!
Joined: 3/31/2008
Msg: 219
FREE Federalized Health Care
Posted: 6/10/2008 10:28:03 AM
The tax laws subsidize ALL students because universities are almost all tax-exempt. So that duty applies no more to a doctor than it does to an accountant.

A "tax break" has no bearing on what specialty a doctor chooses and where s/he practices, just like it would have no bearing on a lawyer vis-a-vis the same choices. Their education was indirectly subsidized by the taxpayer, just as the tution costs are for virtually every degree given at a US and Canadian college or university.

You want to try and force doctors to stay in Canada, but don't think that accountants, teachers, lawyers and other professions, who get the same educational benefits, need to be under the same constraints. That would make doctors a special class of profession, one which gives up civil rights by virtue of entering the profession (much like entering the military).

Good luck with that. I think your courts would throw such a case out.
 flyonthewall!
Joined: 3/31/2008
Msg: 220
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Posted: 6/14/2008 7:12:51 AM
^ ^ ^ ^ ^ Same amount as we actively recruit from Canada -- zero.

It's not about your "butting in", but your making inappropriate comments because you haven't read the entire line of conversation before responding.

I have no idea what you're talking about with the annual salary of school teachers, but I'm sure you'll say some other strange thing in three weeks when you come back to respond.

I'm not trying to "ease my conscience", it's doing quite well -- thank you.

I don't believe in socialized medicine. It was easy to see a doctor when I was a little girl, and no one had insurance for every day medical problems. I saw a doctor every time it was necessary even though my parents were of very modest means in those days. The easiest way to keep the cost of medine down is to remove insurance except for catastrophic health problems.
 Montreal_Guy
Joined: 3/8/2004
Msg: 221
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Posted: 6/14/2008 7:48:42 AM

^ ^ ^ ^ ^ Same amount as we actively recruit from Canada -- zero.


Actually those numbers are less and less, and of no real concern, as I just discovered - rather surprisingly.


Higher incomes, newer equipment and more opportunities - for some Canadian physicians, the United States seems to have it all. i Some critics have long alleged that because of the “exploitative nature of medicare,” Canadian doctors cannot resist heading south. ii More recently, some argue that this brain drain is a “major contributor to physician shortages in Canada,” iii prompting physician associations and ministries of health to launch campaigns to lure expatriate, Canadian-trained physicians back home. iv Fears of physician losses are further fuelled by reports that the U.S. - renowned for luring more physicians than any other country v - could be short 85,000 doctors by 2020. vi

There’s no doubt that Canada - like other wealthy nations - is losing some of its physicians, particularly to the U.S., vii - that this emigration represents a loss for Canadians. However, when it comes to the brain drain, it’s nowhere near a mass exodus. At worst, it’s more a trickle than a flood.
Entry and exit

Physicians enter and leave the country for a number of reasons. For instance, some Canadian doctors go overseas for medical training, then return home to practise. Foreign medical school graduates may arrive with temporary work visas or as landed immigrants, practise in Canada for awhile, leave, and even decide to return eventually. viii

The Canadian Institute for Health Information charts migration patterns for practising physicians. The data exclude interns, residents and doctors who leave Canada right after graduation without ever working here, but they still provide important information on trends. According to the Institute’s data, the gross number of doctors leaving the country hit two peaks in the last 35 years: one in the late 1970s, when we lost between 500 to 600 doctors a year, and another in the mid-1990s, when we lost around 600 to 700 a year. When assessing the brain drain, it’s important to consider not only the number of doctors who are leaving, but also the number returning to Canada. This number has been holding fairly steady since 1980, with around 250 to 350 returning per year. Thus, our net loss of physicians is fairly small - since 1980, our annual net loss has never been more than one percent (and averages closer to one quarter of a percent) of all practising physicians. ix, x

In recent years, not only has the brain drain trend slowed, it has actually reversed. In 2004, there was a net brain gain of 85 doctors. Although this gain has decreased as of late - a net gain of 61 doctors in 2005 and 31 in 2006 ix, x - the data still counter popular perceptions that Canadian doctors are leaving in droves.

The data also disprove claims that the brain drain is responsible for Canada’s doctor shortage. In 2006, there were 62,307 active physicians in Canada - the highest number ever, largely attributable to a more than five percent increase in Canadian-trained physicians over the last five years. ix The 2006 data also show a five percent increase in physicians between 2002 and 2006, which is just over parity with population growth over the same time. ix

An important issue in all of this is where our doctors are coming from. In 2006, of the 238 returning physicians, about 190 had received training in Canada, while the rest were trained mostly in the UK and Ireland, but also South Africa, India and elsewhere. ix In the same year, international medical graduates accounted for 22 percent (13,715 doctors) of the total physician supply in Canada. ix If this means Canada is “poaching” doctors from countries that have a much more limited ability to train physicians and handle internal crises in population health, then this is a serious public policy problem. xi
Destination U.S.

Of the doctors who are leaving Canada, more than half choose to go to the U.S. ix The Canadian Institute for Health Information has been tracking doctors’ destinations only since 1992. Since then, between 60 and 70 percent of physicians who emigrate have headed south of the border. In the mid-1990s, the number leaving for the U.S. spiked at about 400 to 500 a year. However, in recent years, this number has declined, with only 169 physicians leaving for the States in 2003; 138 in 2004; and 122 in each of 2005 and 2006. These numbers represent less than half a percent of all doctors working in Canada.

Popular culture’s obsession with the "mass exodus" of Canadian-trained physicians to the U.S. has meant little attention is given to the movement of physicians from one Canadian jurisdiction to another. In particular, physicians appear to be moving “from less prosperous to more prosperous provinces and from rural to urban areas,” xii which likely exacerbates real shortages in rural, remote and economically disadvantaged areas.
Conclusion

Over time, annual losses of physicians can add up - if we lose even a handful of physicians each year, in 25 years we will have lost a stock of Canadian-trained doctors. This point merits our attention, for educating our physicians is a costly, time-intensive investment - it costs about $1.5 million to train a doctor, much of which is paid for through taxes. xiii There is also the real concern of physician retention in rural and remote areas. vii To address these problems and ensure Canadian taxpayers are able to benefit from their investment, provincial and federal policy makers should focus on co-ordinated national recruitment and retention strategies to retain and sustain our physician supply in all regions of the country.

http://www.chsrf.ca/mythbusters/html/myth29_e.php




About CHSRF

The Canadian Health Services Research Foundation promotes and funds management and policy research in health services and nursing to increase the quality, relevance and usefulness of this research for health-system policy makers and managers. In addition, the Foundation works with these health-system decision makers to support and enhance their use of research evidence when addressing health management and policy challenges. Any Foundation project, process or activity always involves both researchers, and managers, policy makers from academia and Canada's health system.

The Foundation is an independent, not-for-profit corporation, established with endowed funds from the federal government and its agencies.

http://www.chsrf.ca/about/index_e.php


They've done some interesting research, and you can all access it here :


2008
March Myth: Canadian doctors are leaving for the United States in droves

2007
December Myth: Canada's system of healthcare financing is unsustainable

September Myth: Direct-to-consumer advertising is educational for patients

June Myth: Generic drugs are lower-quality and less safe than brand-name drugs

March Myth: We can improve quality one doctor at a time

2006
December Myth: The risks of immunizing children often outweigh the benefits

September Myth: People use health system report cards to make decisions about their healthcare

June Myth: Early detection is good for everyone

March Myth: Medical malpractice lawsuits plague Canada

2005
December Myth: Managed care = mangled care

September Myth: Canadian doctors are leaving for the United States in droves

June Myth: Canada has a communist-style healthcare system

March Myth: A parallel private system would reduce waiting times in the public system

2004
September Myth: We can eliminate errors in healthcare by getting rid of the "bad apples"

March Myth: For-profit ownership of facilities would lead to a more efficient healthcare system

2003
September Myth: Doctors do it for Money

June Myth: The cost of dying is an increasing strain on the healthcare system

March Myth: An ounce of prevention buys a pound of cure

2002
November Myth: Seeing a nurse practitioner instead of a doctor is second-class care

September Myth: Bigger is always better when it comes to hospital mergers

January Myth: The aging population will overwhelm the healthcare system

2001
September Myth: User fees would stop waste and ensure better use of the healthcare system

2000
December Myth: More Money Would Put an End to Emergency Room Crunches

http://www.chsrf.ca/mythbusters/index_e.php


I'm sure some of those may assist those of you looking at the Canadian model for ideas.
 flyonthewall!
Joined: 3/31/2008
Msg: 222
FREE Federalized Health Care
Posted: 6/14/2008 11:37:27 AM
The number of doctors returning to Canada aren't necessarily coming from the United States. The typical scenario of physician who comes to the US and never returns is one who comes here after medical school for a residency. That resident likes the better equipment, and closer access to top medical specialists and Nobel Laureats. They also may have met their potential spouse and decided to stay here. Usually money is not the catalyst for those particular doctors. About 2/3 of Canadian medical and surgical residents return to Canada, and 1/3 stay here.

According to the following articles:

http://www.straightgoods.com/Analyze/0018.shtml

http://www.cbc.ca/health/story/2006/10/12/doctors-migrate.html

About 1,000 high income professionals per year leave Canada for the purpose of better income, and fewer taxes, at least a few hundred of which are doctors -- but these are not the majority of doctors who leave the country.

The doctors who are returning to Canada are older. They probably think they've made their money, and will practice for a few more years at a slower pace before they retire. According to the same article, there is a surplus of doctors coming to Canada each year that slightly beats the increase in your population. However, if those doctors are in their 40s and 50s they don't have that many years left to practice. What Canada really needs to attract are the YOUNGER doctors, because they will be practicing medicine for another 40 years.

One thing that Canada has done right is make it easier for foreign doctors to practice in the country. Up until a couple of years ago you had doctors driving cabs because they couldn't get licensed in Canada. It is still difficult, but some inroads are being made to get them practicing medicine instead.
 designingwoman
Joined: 9/4/2005
Msg: 223
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Posted: 6/14/2008 1:42:56 PM
In Canada, doctors can count on a steady stream of income, as opposed to only so much from private insurance companies. They can also spend more time on patient care instead of fighting it out with greedy private health insurance companies. I can see why people would want to practice medicine in Canada as opposed to the US. It's getting worse for American doctors every year--their incomes are going down due to two things that can be tied to corporate greed: Private health insurance companies, and malpractice insurance. The malpractice companies are soaking the doctors here like crazy, and that's not right!
 sup4man99
Joined: 3/21/2007
Msg: 224
FREE Federalized Health Care
Posted: 1/5/2009 6:04:40 PM
I am glad Obama won, because he says that he plans to reform the healthcare system. Most of my family works in hospitals and from what I have seen, the system needs to be at least slightly modified if not strongly reformed.
 designingwoman
Joined: 9/4/2005
Msg: 225
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FREE Federalized Health Care
Posted: 1/12/2009 4:08:22 PM
I hope that Obama can get HR 676 passed, or at least give people the chance to opt out of private health care and opt in to a government plan. If enough opt in to the government choice, perhaps we can finally see the private health insurance industry die a slow death as people opt out in droves!!!
 flyonthewall!
Joined: 3/31/2008
Msg: 226
FREE Federalized Health Care
Posted: 2/3/2009 9:41:20 AM
HR676? Obama isn't in favor of universal health care. He wants to give the general public the opportunity to buy into programs similar to the Federal Employee Health Benefit Program (FEHBP) and Medicare filling in with Medicaid for those who fall between the cracks.

Obama's health plan is much more conservative than Hillary Clinton's, which was still far, far from HR 676. That bill is dead, dead, dead.

Further, with the economy the way it is, health care is way, way down on the list of issues that need attention.
 AceOfSpace
Joined: 5/28/2007
Msg: 227
FREE Federalized Health Care
Posted: 2/4/2009 10:36:06 AM
With health care costs taking up 17% of our national GDP and producing literally nothing marketable, I would say that it is a very urgent priority! Before the collapse of the housing market, the leading cause of bankruptcy was unplanned health costs.

The insurers are destroying us just as surely as the financiers. In fact, they're often the same people.
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