希望大家在选举中关注医疗体系改革问题

[山清水秀]

我没有查过法规，不知道加拿大是否禁止私人开诊所或者建医院。

我想，应该没有禁止的法规。眼下没有私人诊所或者私立医院，不是因为禁止，而是没有人干。为什么没有人干，道理是显而易见的。

道理是显而易见的? 没看见也。

 

[苦逼热狗]

好像有个health council of canada，而且不允许没有医学背景的投资家做领导。

 

[ccc]

道理是显而易见的? 没看见也。

能保证有足够的富人生病么？换句话说，即便有足够的富人，他们得病就一定来你这私立看病、住院吗？

不赢利、没有较高的利润，谁去干啊。除非你开诊所、建医院是为了搞慈善事业。

 

[viper99]

中国的情况大家都知道，只是一般而言我们在国内的亲朋好友都还是看得起病的，所以很多人感觉中国的医疗更有效。

我在Singapore住过几年，我觉得他们的经验有可取之处。
公立医院收费很低，住院有补贴，公民/PR/外来居民补贴不同。
象我这样的一般收入者，小病不会去公立医院，嫌排队太久。私立诊所就方便很多，环境也好，$50到$100一次也不算贵，很多公司还可以claim。
同样的病公立医院只收不到$10，很多低收入者不介意等2小时。
但大病需要住院的，一般人都会选公立医院。我的几个朋友生小孩都是选的国大医院。几千块吧，不确定。有钱人可以选私立，要几万了。

也许Canada也可以多几间私立医院？

诸位，设立私立医院（国家财政绝对不可以补贴）的方案早就有人提出了（我个人也不反对）， 具体原因我记不住（太多了），就是没有实施起来。

骂死他大，你我的亲友在国内看得起病是因为你我的亲友在国内属于相对有钱的家庭，比如你我早早就出国了，但有许多中国平民家庭看不起大病也是不争的事实， 广大的农民（真实的农民不是那种城郊卖地富裕起来的那部分人），城里的广大农民工，城里的无医疗保险的平民，他们跟新加坡人跟本不可相提并论，他们生大病了，哪里有钱，谁给他们钱看病？

在加拿大生孩子医院不要说收几千块，一分钱都不收啊。

加拿大医疗系统如何改进，真的是大问题，美国穷人看病也有问题，奥巴马不是要医改吗。

 

[小傻]

The legal basis for Canada's healthcare system

• The Constitution Act (1982) assigns responsibility for most health care to the provinces (the national government retains responsibility for aboriginal populations covered by treaties, the armed forces, and members of parliament)
• The Canada Health Act (1984) consolidates and defines the principles of the publicly funded healthcare system, known as Medicare. The five principles are comprehensiveness, universality, portability, public administration, and accessibility
• The Canada Health Act requires that all hospital and physician services be (virtually) 100% publicly financed without user charges. Third party insurance for these services is prohibited. Physicians can “opt out” of their provincially operated Medicare plans, with no state financing of care. There are nuances in how individual provinces regulate this provision, but uptake is very small
• The Canada Health Act is silent on other services, resulting in a patchwork of coverage arrangements that varies considerably from province to province
• The federal government has long shared tax revenues and negotiated cost sharing agreements with the provinces. It used its fiscal levers to engineer the key legislation that created a national Medicare system in the 1950s (Hospital Insurance and Diagnostic Services Act 1957) and 1960s (Medicare Act 1966). Its ability to enforce provisions and penalties under the Canada Health Act is contingent on its power to withhold fiscal transfers to offending jurisdictions

<SCRIPT type=text/javascript src="/portal/portal3rc.fcgi/rlib/js/InstrumentOmnitureBaseJS/InstrumentNCBIBaseJS/InstrumentPageStarterJS.js"> </SCRIPT><!-- PmcSite: '', // See ipmc-prod:5701/internal/PMCSites.xml BackendHostName: 'ipmc3' --><!--396D2FB9D8CAD391_0131SID:/projects/PMC/PPMC:2.4ortal203:v2.12.r220559: Fri, Jan 21 2011 12:34:34-->
A taxonomy of private health care in Canada

• Most (70%) health care in Canada is publicly financed, but almost all is privately provided. Almost all hospitals are non-profit private societies or corporations. Most non-academic physicians are “fee for service” private practitioners. Long term residential care and home care are variously non-profit, state owned, or for-profit, with different mixes in different provinces
• About half of prescription drug costs are borne privately, either by patients themselves or through third party insurance. All provinces have drug plans that cover certain populations, such as elderly people and those receiving welfare or with special needs
• Recently, increasing numbers of private, for-profit clinics have appeared offering services such as magnetic resonance imaging, cataract and corrective eye surgery, and rehabilitation (particularly physiotherapy). Practices range from totally private transactions, to purchase of services by regional health authorities on behalf of their populations, to third party insurance purchase of rehabilitation services

<SCRIPT type=text/javascript src="/portal/portal3rc.fcgi/rlib/js/InstrumentOmnitureBaseJS/InstrumentNCBIBaseJS/InstrumentPageStarterJS.js"> </SCRIPT><!-- PmcSite: '', // See ipmc-prod:5701/internal/PMCSites.xml BackendHostName: 'ipmc1' --><!--396D2FB9D8CAD391_0131SID:/projects/PMC/PPMC:2.4ortal207:v2.12.r220559: Fri, Jan 21 2011 12:34:34-->source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1121447/

 

[苦逼热狗]

终于等到了相关人士的出面了

 

[小傻]

诸位，设立私立医院（国家财政绝对不可以补贴）的方案早就有人提出了（我个人也不反对）， 具体原因我记不住（太多了），就是没有实施起来。
..。

如果国家财政不补贴，保险公司不REIMBURSE，私立医院根本不可能存活。。

 

[viper99]

如果国家财政不补贴，保险公司不REIMBURSE，私立医院根本不可能存活。。

That's the point!

 

[山清水秀]

The legal basis for Canada's healthcare system

• The Constitution Act (1982) assigns responsibility for most health care to the provinces (the national government retains responsibility for aboriginal populations covered by treaties, the armed forces, and members of parliament)
• The Canada Health Act (1984) consolidates and defines the principles of the publicly funded healthcare system, known as Medicare. The five principles are comprehensiveness, universality, portability, public administration, and accessibility
• The Canada Health Act requires that all hospital and physician services be (virtually) 100% publicly financed without user charges. Third party insurance for these services is prohibited. Physicians can “opt out” of their provincially operated Medicare plans, with no state financing of care. There are nuances in how individual provinces regulate this provision, but uptake is very small
• The Canada Health Act is silent on other services, resulting in a patchwork of coverage arrangements that varies considerably from province to province
• The federal government has long shared tax revenues and negotiated cost sharing agreements with the provinces. It used its fiscal levers to engineer the key legislation that created a national Medicare system in the 1950s (Hospital Insurance and Diagnostic Services Act 1957) and 1960s (Medicare Act 1966). Its ability to enforce provisions and penalties under the Canada Health Act is contingent on its power to withhold fiscal transfers to offending jurisdictions

<SCRIPT type=text/javascript src="/portal/portal3rc.fcgi/rlib/js/InstrumentOmnitureBaseJS/InstrumentNCBIBaseJS/InstrumentPageStarterJS.js"> </SCRIPT><!-- PmcSite: '', // See ipmc-prod:5701/internal/PMCSites.xml BackendHostName: 'ipmc3' --><!--396D2FB9D8CAD391_0131SID:/projects/PMC/PPMC:2.4ortal203:v2.12.r220559: Fri, Jan 21 2011 12:34:34-->
A taxonomy of private health care in Canada

• Most (70%) health care in Canada is publicly financed, but almost all is privately provided. Almost all hospitals are non-profit private societies or corporations. Most non-academic physicians are “fee for service” private practitioners. Long term residential care and home care are variously non-profit, state owned, or for-profit, with different mixes in different provinces
• About half of prescription drug costs are borne privately, either by patients themselves or through third party insurance. All provinces have drug plans that cover certain populations, such as elderly people and those receiving welfare or with special needs
• Recently, increasing numbers of private, for-profit clinics have appeared offering services such as magnetic resonance imaging, cataract and corrective eye surgery, and rehabilitation (particularly physiotherapy). Practices range from totally private transactions, to purchase of services by regional health authorities on behalf of their populations, to third party insurance purchase of rehabilitation services

<SCRIPT type=text/javascript src="/portal/portal3rc.fcgi/rlib/js/InstrumentOmnitureBaseJS/InstrumentNCBIBaseJS/InstrumentPageStarterJS.js"> </SCRIPT><!-- PmcSite: '', // See ipmc-prod:5701/internal/PMCSites.xml BackendHostName: 'ipmc1' --><!--396D2FB9D8CAD391_0131SID:/projects/PMC/PPMC:2.4ortal207:v2.12.r220559: Fri, Jan 21 2011 12:34:34-->source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1121447/

 

[ccc村长]

如果国家财政不补贴，保险公司不REIMBURSE，私立医院根本不可能存活。。

所以没有人干啊。就如同没有政府补贴，没有人搞公共汽车服务一样。

美国有私立的，是因为他们没有我们这样的全国统一的公费医疗系统。

 

[wiki]

其实更应该改善的是家庭医生制度。很多人一生病就往医院跑主要是没有家庭医生，也不知道可以去附近Walkin。我们缺的不是专家，而是General Physician。改善这个问题其实并不难，允许移民将国外行医经验认证，在加拿大行医就行。移民部嚷嚷了很多年这个foreign credential referral office也不见效果，根本原因还是官僚！

还有就是习惯问题，比如我们中国来的习惯了去医院，大病小病都往医院跑，医生不给开药就觉得人家水平不高是庸医。

 

[闲哥]

大家说的都很好，　下面我来补充几句．

１　医疗其实主要是省政府的事情，　联邦政府基本没什么权利干涉的．　所以这个话题在省选的时候提出来更有效果．　

２　现在加拿大的医疗投入不是太少了，　是太多了．　关键问题是好钢没用在刀刃上，　浪费严重．　５０％的资源被１％的人用掉了．　　比如老年人腰酸背疼的正常老年现象也总跑医院．比如９０多岁的垂危老人在ＩＣＵ躺几个月，　每天的费用都上万啊同志们．

说完了，　大家可以鼓掌了．

 

[山清水秀]

大家说的都很好，　下面我来补充几句．

１　医疗其实主要是省政府的事情，　联邦政府基本没什么权利干涉的．　所以这个话题在省选的时候提出来更有效果．　

２　现在加拿大的医疗投入不是太少了，　是太多了．　关键问题是好钢没用在刀刃上，　浪费严重．　５０％的资源被１％的人用掉了．　　比如老年人腰酸背疼的正常老年现象也总跑医院．比如９０多岁的垂危老人在ＩＣＵ躺几个月，　每天的费用都上万啊同志们．

说完了，　大家可以鼓掌了．

啪啪

 

[viper99]

如果国家财政不补贴，保险公司不REIMBURSE，私立医院根本不可能存活。。

能保证有足够的富人生病么？换句话说，即便有足够的富人，他们得病就一定来你这私立看病、住院吗？

不赢利、没有较高的利润，谁去干啊。除非你开诊所、建医院是为了搞慈善事业。

楼上有些朋友说开私立医院，不是政府不容许，而是你如何生存？完全自费的话，有几个病人去？加拿大人口本来就少，多大的城市可以有足够多的有钱的病人能养活一家完全自费的医院呢？

我强调国家财政不补贴　（保险公司属于私有企业他们脑子聪明着呢，不需要我们操心），是因为如果财政补贴，钱还是得我们纳税人出，还会是个无底洞啊　等于我们要交更多的钱给有钱人看病啊

至于说拍个片子，做个ＣＴ这样的单一的医疗服务，可以私人开啊，完全是市场问题

 

[小傻]

美国有私立的，是因为他们没有我们这样的全国统一的公费医疗系统。

奥八马梦想着建立一套全民医疗体系。。估计对他只能是梦想了。。

一些新技术，特别是MOBILE DEVICES在HEALTH CARE领域的应用，将会有革命性的突破。。我回来可以百科一些这方面的动向。。