Now for the fun part 🔥 I've done 2 videos on the Canadian vs. American healthcare systems and have had conversations with many different people on both sides of this issue - so I want to turn the conversation over to you. Which system do you prefer and why, either as a doctor or as a patent... or both. How would you improve the systems realistically and what obstacles do you see to your plan? (Yes this question is often used as an assignment in many university bioethics classes 😅)

I’m in the US, and I think this was a very balanced presentation. Usually, proponents of the Canadian, UK, Australian, etc systems seem offended at any notion that there are instances where the US system may provide more timely or more complete (in the sense of imaging availability for instance), which makes a substantive discussion difficult. And, of course, we can be touchy on our side as well 😉

@nxtgenmd

8 ай бұрын

Thanks for the feedback Bonnie :) I agree, comparing and contrasting the systems was a really "interesting" process for me to say the least 😅 There are 2 different systems for a reason and each has their own pros and cons. All the best

I live in Ontario and once witnessed a man with a dislocated shoulder wait in the emergency room along me and my mother for 8 hours to see a doctor for around 2 minutes to then order an x-ray. We waited around an hour and then had to wait again to see the doctor for the result for an extra hour. I spent quality time with my mom tho right 😂😂

@nxtgenmd

8 ай бұрын

I wish I could laugh, but that sounds terrible lol. I'm glad you had some bonding time :)

Gianluca, thanks for shedding light on the healthcare scene in Canada and the USA! Your comparison breakdown is so helpful. It's concerning to see the challenges both systems face, but your insights make it easier to understand. Looking forward to more of your videos!

@nxtgenmd

7 ай бұрын

Thank you :) comparisons are difficult, especially about nuanced topics. But hopefully things will improve in the future if we talk about them instead of ignoring them. All the best with everything

Windsor, Ontario. I had to wait with my brother 9 hours in the emergency room for a broken arm.

Something I wish you would have discussed is accessibility to the working class patient. Privatized healthcare in the USA is not affordable for many people, especially if they don't have enough insurance from their workplace. Do you maybe think that could be a factor leading to short wait times? Programs like OHIP give residents the ability to switch jobs, take breaks, and retire without worrying that they can't afford life-saving medical treatment. Switching to a private model would cost less for the government, but that cost would be placed on the shoulders of individuals. Of course, the push to privatization has been fuelled by the incredibly wealthy who are simply looking to hoard more wealth in society. While I'm sure this would be favourable to those more concerned with paying taxes than contributing to their society, it would completely crush any hopes the average Canadian would have of receiving healthcare at an affordable rate. In fact, it's not uncommon for Canadian citizens living in the USA to visit Canada to receive medical treatment. Not needing to sell your home to afford treatment may be alien to the tall midgets of our society, who think making a 6-figure salary makes them immune from poverty, but you're still far closer to homelessness than you are to being a billionaire. I don't feel like the numbers you presented in this video fully frame the differences between public and private healthcare, and I hope you spend more time on the social differences in future videos. If you have access to the data, also consider how healthcare has changed since neoliberalism took hold in the 70s. Many boomers look back fondly on how good life used to be, but they don't realize that policies in the USA and Canada pre-1970 had many more features of social democracy ("social liberalism"). These policies were created as concessions between the liberals and the working class to reduce enthusiasm for socialism, but they've been slowly peeled back over the last half century by neoliberal policy. For readers in Ontario and Canada, both our provincial and federal Liberal and Conversative parties are on the same page in regards to economic policy. We are living in a de facto one-party state, and so are people in the USA. Although I will take your word that you're not cherry-picking data, I do think you're essentially doing propaganda for neoliberals by providing raw data without thorough interpretation. To frustrated readers in Ontario, please also remember that Doug Ford is still sitting on billions of funding provided by the Federal Liberals to use during the COVID-19 pandemic. "Starve the beast" and then replace it with private clinics owned by your business partners...

@nxtgenmd

8 ай бұрын

Hi there :) Thanks for the feedback. While I reject the notion that my freely available data is "propaganda" or was done to further some political agenda, you are entirely entitled to your opinion. Please remember that while many of the aspects mentioned in your comment are incredibly important, they do little to explain to my patients why they needed to leave the ED without being seen or were outright declined to receive a specialist referral. There is not a single doctor working today that would disagree with the notion that our system is strained with only approx. 1/10 the population of the United States. While people may feel like it works for us, we cannot assume that similar results would be seen if adopted by the USA. All the best

@exreal9864

8 ай бұрын

@@nxtgenmd I appreciate your response. Here's what you said: "The Canadian health care, sometimes, gets romanticized when we look at it on the news and, as a result, certain political institutions use it to push agendas. Let's talk about the facts here today and see what the experience is actually like between the two different countries." 1. You're saying that a "romanticized" health care system is used to "push political agendas." Before even presenting any data, you're already framing the issue as political, and attaching a negative connotation to parties "pushing" the "romanticized" health care system. Clearly, you're already taking an opposing stance to this agenda pushing (i.e., that of a publicly funded healthcare over a privately funded healthcare). Within the first two minutes, you've already demonstrated a bias against publicly funded healthcare and the parties "pushing" that as their agenda. You spend the next 9 minutes of the video comparing wait times and access to new pharmaceuticals of the 2 healthcare systems. 2. Instead of consistently sourcing peer-reviewed articles, you use various news articles without disclosing their political leanings. For example, The National Post, Globe and Mail, and CTV have all demonstrated right-wing bias. 3. You use multiple articles written during the COVID-19 pandemic, but fail to mention how the pandemic could have influenced the factors presented. I wonder, did the country have difficulty finding beds for patients during the pandemic? Were walk-in clinics, specialist offices, and elective surgery offices working at reduced capacity and with stringent sanitation measures? Could these have maybe contributed to these increased wait times you present in the video? The page at 8:36 quite literally says that numbers should be interpreted with COVID-19 restrictions in mind, but you've provided no such interpretation. 4. You use "medimap" to show the average wait times for walk-in clinics, but then proceed to discredit it with anecdotal experience. 5. You say that 1/3rd of pharmaceuticals available in Europe "hadn't even been submitted" to Canada. You don't explain why these late submissions are a fault of the Canadian system, but use it anyways in an overall argument against the Canadian healthcare system. 6. You say the paper mentions that the ~3/4 of pharmaceuticals submitted late to Canada had counterparts already available in the country, but then discredit it with anecdotal experience. You then finish off the video saying that our life expectancy is higher than that of the USA, but then proceed to minimize its relevance by referring back to the points discussed in the video. You provide no interpretation for why our life expectancy could be higher than that of the USA, despite spending the entirety of the previous section presenting negative points of the Canadian healthcare system. Despite all the negative points you've presented, you make no effort to interpret how they put the higher life expectancy into question. Reading through all of that, do you still not consider yourself as a propagandist? You've either acted incredibly dishonestly through your presentation, or you've demonstrated a seriously unscientific attitude. Considering your initial framing, I think I'll put my bets on the former. Now, let's take a look your response to my first comment. "Please remember that while many of the aspects mentioned in your comment are incredibly important, they do little to explain to my patients why they needed to leave the ED without being seen or were outright declined to receive a specialist referral. There is not a single doctor working today that would disagree with the notion that our system is strained with only approx. 1/10 the population of the United States." Hmmm... I'm not sure? Maybe you should have talked about the COVID-19 pandemic's impact on the healthcare system? As a doctor in Ontario, I'm sure you're aware that our provincial government for the last 6 years has been Conservative. Healthcare, of course, is also a provincial issue. Provincial conservatives are sitting on billions of healthcare funding provided to them by Federal Liberals for use during the COVID-19 pandemic. They're also pushing for privatization of our healthcare system. It almost seems like they want the healthcare system to fail so they have an excuse to privatize it. Maybe tell your patients not to vote for people against their best interest? If you'd provided metrics over time, maybe your question would be clear to viewers. "While people may feel like it works for us, we cannot assume that similar results would be seen if adopted by the USA." Sorry, not really sure what you're getting at here. Look, I've been a long-time supporter of your channel. I can understand that this comment could seem rude or unfair to you, but there needs to be accountability when you're engaging in a political discussion as an authority figure in medicine. I hope you use this criticism to provide more thorough analysis when talking about this topic.

@nxtgenmd

8 ай бұрын

@@exreal9864 Discussion is important - I take no offence whatsoever, I just disagree. I have made every attempt to remain consistent given the resources that are available - I start the video off by saying that accessing this information is difficult since it is not available in 1 location. I needed to draw information from multiple sources but make all references available. When speaking anecdotally, I always preface this first. Thank you for the support over the years and all the best

@exreal9864

8 ай бұрын

​@@nxtgenmd With all due respect, that hardly addresses anything I've said in the comment. Because you seem determined to present a dishonest narrative, I can't in good faith continue to support your channel. I wish you the best in your medical career, and I encourage you to seek further education in politics.

As an immigrant to Canada, I find we have less obesity here which might contribute to the life expectancy differential

Such a great video I would love to know if the American Health care total spend does include, pharmacy, dentistry and other adjunct medical fields that the cdn system does not. 🎉

On my interview trail for the US residencies right now so this was a fun watch. Looking forward to the less than 1 hr ER wait times😄sounds too good to be true. I usually don't even bother asking for a specialist referral as a patient in Canada anymore because I know i will be gone by the time i get the appointment.

@nxtgenmd

8 ай бұрын

Awesome stuff dude! Best of luck with the interviews, I'm sure you're going to crush them 💪 Specialist referral is a frustrating process for sure - definitely something that I spend a lot of time talking about with my patients.

@chrislifts2981

8 ай бұрын

thanks man excited to let you know where i hopefully match this year@@nxtgenmd

I always thought of Canadian Medicare as just health insurance that pays the bills. It sounds like most Canadian hospitals are also government run as well? Is there any data about private hospitals in Canada working better than the government run ones?

I'd rather wait 5 hours than pay my life savings to see an ER doc

@nxtgenmd

8 ай бұрын

You are not alone with that mindset. All the best

When discussing these topics, you have to go into detail, and I don't think you can't get political. Because a lot of the wait time issues in Canada come down to the government not building new hospitals, etc for a growing population. The USA is such an un-equal place for healthcare, that you have people waiting longer in the ER than in Canada in some cases. Then you have people waiting 20 min at for profit ERs that slightly cook the books by sending in a doctor or nurse to say hello, and count that as seeing the doctor. It's a very complexe system there, and for profit systems can manipulate the data. Not to mention the millions that don't go to the ER, because they dont have insurance. Or the thousands of places that have lost a hospital in the USA, because it is not profitable. Those all play into ER access. It's hard to have a ER wait time when there's no hospital to go to. I can tell you from people I know, sometimes Canada gets the new drug first. That is just approval processes. What I do know is that health systems across the world, including the USA are suffering under strain. Be they Canadian single tier, or two tier like Australia and the UK. People are waiting everywhere in ERs for non urgent cases. Also discuss what you are doing to rectify the crisis. A ER doctor in Hamilton redesigned how the ER at St Josephs works. They consistently have wait times under one hour, while neighboring ERs have 5 hour waits. Why is that practice not being expanded to other ERs?

My primary care provider is a PA. I haven't seen a doctor in years. I'm in the US BTW.

In Alberta my neighbor had to wait at least a year to get on a wait list for the wait list to get an appointment. Ot took another year. Surgery was even further behind and it was a eight month wait. The morning of her hip replacement a emergency hip replacement arrived in the ER. The doctor told her that surgery will be canceled because of the emergency. He asked if she was OK. She wasn't, she was waiting in pre-op at the time. She flat out, straight faced told him if he dies she's going to kill herself. He took her serious and did the surgery. The next morning he apologized tk her because when they went in her case was worst possible with bone necrosis and more. Because it was so bad, she still has pain even with a new hip.

Respected Dr. Does ophthalmologist tend to make more then cardiologist here in canada and what salary should i aspect as an IMG opthalmolohist From India...pls reply

@nxtgenmd

8 ай бұрын

You would be best off looking this up on a CMA approved resource. Best of luck

@PranavbirSingh-qv6hu

8 ай бұрын

​@@nxtgenmdThnks for replying 😊

ok

Yeah but they make the journey a living hell for international healthcare workers to work there…. 😅

@nxtgenmd

8 ай бұрын

Acceptance to medical school for Canadian applicants is less than 7.5% nationally. Unfortunately, the process is not easy for anyone looking to enter healthcare. Best of luck with everything!