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DonC

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Posts posted by DonC

  1. I am an emergency physician. 85% of the patients we see have insurance. The 15% that do not have insurance have help in some form, from discounts to total write offs of the bill, at least in the hospitals, unless they are well off.

     

    The US system expediently takes care of virtually everyone usually, regardless of financial status. We do not have much waiting unless the specialist can not see a patient in the office if they overly busy, and there may be a few weeks of waiting for nonurgent situations.

     

    There are good and bad anecdotes with the Canadian system it seems, and also with the US system. Americans are used to being taken care of in a reasonably quick timeframe, and that usually is the case.

     

    We pay more of our GNP for the luxury of our system. I would pick the US system for uniform consistency of excellent care. I can not comment on other systems that are reportably less costly, and leave that to those who live in those systems.

     

    Regarding writeoffs, in the state I am in, there is reimbursement for a small portion of the losses. The writeoff is the part of the bill that the patient does not pay.

     

    Don

  2. Johnny Bass,

     

    I am not an OB/GYN. I would guess that the costs would be in the tens of thousands potentially. Most hospitals eventually write off what they can not collect. My brother-in-law had around $30,000 written off. He was diabetic on dialysis in his early 50's. Passed away at age 52.

     

    My brothers who choose to not pay for insurance take the risk. There are some in the US with medical conditions that are not insurable.

     

    Medicare and Medicaid are going broke. We have a tremendous system for prompt patient care. How long can we afford it with over-utilization and the defensive medicine we are forced to practice remains to be seen.

     

    I have not seen anything the looks to be passible by the government to deal with situation given current politics, and do not have much faith in a universal health system, though Canadians seem pleased frequently with theirs. We can not afford the current socialized health programs as structured in the future.

     

    I support fully the medical care system we have. We need to change the patient's stake in the cost of medicine where they benefit when not over-utilizing the system, and have the relief that Canadian doctors have from malpractice.

     

    Don

  3. Minnow

     

     

     

    Group: Members

    Posts: 33

    Joined: 21-May 07

    From: Tennessee

    Member No.: 1,776

     

     

    Buried at the end of a long thread on the Canadian Health Care System is my post. For those who do not want to read the prior 38 posts.

     

    I work in an ER in the US. I will relate our situation, an anecdote and an opinion.

     

    We see 85,000 patients per year. 90%-95% of those patients are in a room within 30-45 minutes ready to be seen. 90% of the patients are seen within one hour by a doctor or physician assistant after checking in at the front desk, and around 75% of patients are seen within 30-45 minutes after checking in. Many ER's are not so timely. We run around 3.5-4 hours on average to be admitted to the hospital and 2.5-3 hours to be discharged home after signing in to the ER. 15% of our volume have no insurance. 28% have Medicaid and 32% have Medicare. 26% have commercial insurance.

     

    My hospital, as many others, have programs for patients with limited means and no insurance. If you make less than $13,000 per year for a single person, you have no bill whatsoever from the doctors in the ER and any hospital based doctors, and no hospital bill. If you are single and make less than $18,000, you get a 60% discount. If you have 2 children, a spouse and make less than $40,000, you get a 40+% discount.

     

    Within the past 2-3 years there have been successful lawsuits against multiple hospitals that gave 50% or so discounts to commercial insurance plans and none to uninsured patients. If we can give up to 55% discounts to insurance plans, and up to 70% discounts to Medicaid (government requires the discounts), then it is fine to give discounts to uninsured.

     

    No one is turned away from the ER. On occasion they may have difficulty finding a doctor to follow them up. Usually everyone is taken care of with infrequent exceptions after they leave the ER. Office based doctors give a portion of their care away free. If a patient needs admission, we have a call list if they have no doctor, without regard to financial status. All care is given regardless of financial status in my ER and hospital. We do not delay care to check on insurance status. To do so is illegal.

     

    We have a utilization problem in the US. Over and under-utilization. Patients almost always have no financial stake in their care. We have an aging population, with increased technology and patient expectations, an ever increasing medical liability situation driving unnecessary testing and admissions. If patients had a medical savings account, paid by government out of existing funds, or through some tax incentive, then the patient would be more involved in the cost of evaluation and treatment. They would have an financial incentive to not have unnecessary testing and utilization. We can not afford the cost in the future without proper utilization. We need legal relief from the malpractive connundrum.

     

    An anecdote: The owner of the lodge in Ontario we go to each year has a home in a town of around 50,000 or so in Florida for the winter. She had a heart attack 2 years ago in Florida. 35 minutes after the chest pain started at home, she was in the cardiac cath lab at the local hospital getting the coronary blockage opened up and had virtually no damage to her heart. Not many places in the world would that occur so promptly. They have a policy that covered the cost. They are Canadian citizens.

     

    Socialized medicine, which at my ER represent 60% of our volume, is great for those on it. The doctors have a 10.6% cut coming next month unless reversed by Congress. If that happens, and the future cuts in the coming years occurs, then they will have trouble finding doctors. They will still receive care in the ER. Our government health programs are going broke in the coming years. We get paid around 33% of what we charge in the ER. I am OK with that, but not with a 25% projected further cut in reimbursement in the next 5 years. Either patients are going to need an incentive to utilize the program correctly, or the medical system, nurses, doctors and midlevel providers with take a cut in reimbursement. Many doctors in offices do not break even on Medicaid patients due to paperwork and other costs, with the low reimbursement, which is sometimes around 10% of what they charge.

     

    I estimate that 25% of what we do is defensive medicine. If we had the relief from medical malpractice that Canadians doctors have, then we could save some significant money. That will never happen. The trial lawyers have the democratic party in their back pocket. We have had some legislative relief here and there, but not to the extent really needed to change the situation.

     

    To summarize: The US health care system is very consumer oriented. We need changes to improve utilization and relief from having to practice defensively.

     

    Don

     

    PS: I have 3 brothers who choose to not have health insurance. That is their freedom of choice, and to live with its consequences. We lose our individual freedoms for the mantra of Societal Greater Good.

  4. UF,

     

    I started taking them in the boat when they were around 4 or so. My youngest I probably took younger than 4, but do not recall if I had a boat then. Took my son to Canada on his first trip when he was about 6. With the short attention span, it is very important that they catch fish as quickly as possible, otherwise have something else to occupy them if the fish are not cooperating.

     

    I do not recall things over the past 20 years precisely with the kids on the water. It runs together over time. My youngest daughter outfishes her "hunter" boyfriend usually, but at age 22 does not actively pursue fishing. I took her and the boyfriend out fishing after dinner one evening. I hooked the 44 inch muskie on a tube with 8 LB. test, and let her bring it in. She then wanted to fish for bass some more and started catching smallmouths.

     

    So my advice is take them fishing, but be careful to not burn them out if they get bored and want to do something else at the time. Just take them routinely over the years and try to make it fun for them.

     

    Don

  5. Just returned from last Saturday from Minaki.

     

    The fishing was very good. Had my wife, 2 daughters and others to make a group of 10. Stayed at Birch Island Resort. Very good accommodations, equipment and food.

     

    Fishing for smallmouth, I caught a 44 inch muskie and another in our group a 49 inch muskie. My daughter caught a 27 inch walleye also on a tube in 5 feet of water fishing smallmouth.

     

    We had our best day for smallmouth, catching 145 for our boat. Personally caught 5 smallmouth 18 inches and larger for the week. Largest for me was 19.5 inches. Caught most on tender tubes, color was green pumpkin with orange flake.

     

    The largest walleye in the group was 28 inches. Daughter and fishing partner both caught 38 inch pike.

     

    The fishing is improving on the Winnipeg River. Not many fisherman out this year.

     

    Good fishing for all fsihing Canada this year,

    Don

  6. Enjoyed good times at Casa Blanca the past 2 years with Bryan. We did the American Plan. Food was very good.

     

    Fishing for smallmouth is great. Caught smallmouth up to 20 inches. A lot of fun fishing below Chaudiere Dam for smallmouths. Caught some 15 inch white bass for the first time which surprised us. Never knew they were in the system. Hooked a 40+inch muskie there too but could not hold it more than 2 minutes in the current from shore.

     

    Fish the docks behind Sandy Island at the mouth of the French for smallmouth.

     

    Sad to see the lodge owners struggling with business. The gas prices, exchange rate and creel limits are doing a job on them over all Canada. Personally I agree with improving the fishery with slot and creel limits.

     

    Have a great time,

    Don

  7. Here are my brother John's reply to 2 questions.

     

    Reply to spooner – post #9

     

    All of the in-seat (or under-seat) flotation was left in place – no need to remove any of it.

     

     

    ---------------------------------------------------

     

     

    Reply to Pigeonfisher – post #5

     

    Here’s the cost breakdown for the entire rig (Spring 2006, U.S. dollars, including tax):

    4250 Lund SSV-18

    450 Lund boat cover

    200 Cover support bows/hardware

    1800 EZ Loader trailer

    7500 Evinrude E-TEC 60 hp

    370 Three Cabela’s AGM 12v batteries

    160 Pro Sport 20 plus battery charger

    800 Minn kota Powerdrive trolling motor

    800 Two Humminbird sonars

    60 Two 6-gallon fuel tanks

    500 Four Tempress seats

    300 10 stainless seat bases

    100 Four 13” seat pedestals

    150 Four stainless seat mounts

    150 Two 3/8” sheets marine plywood

    120 Deco Dot vinyl for floor (5 running yards)

    1500 Hardware: extruded aluminum; stainless steel nuts, bolts, etc. (high estimate)

    225 Five nets for side storage

    45 Portable running lights

    45 Hatch cover

    50 Rule bilge pump

    500 Whatever else I bought but couldn’t recall for this list

    $20,075 TOTAL

     

    Although I aspired to create an affordable rig, my main objective was to create exactly the boat that I wanted. After completing the project, I saw ways to create a really nice walleye rig for about $15,000 (by coincidence, the very price that you mention). It wouldn’t be exactly the same as the above rig, but it would be similar in many ways. I’m in the process of writing an article, for posting on my website, that explains how it could be done. I expect to have it written in a few weeks.

  8. Bigcreek,

     

    Four of us brothers fished 4 days at Casa Blanca this year and last year. Bryan had a different woman working for him each year. This year the food was outstanding. The woman had worked as a chef for years. We were the only ones in camp in mid July. By oldest brother brought his modified Lund 18 foot SSV boat, which if you are interested in how it was created, is at http://www.correllconcepts.com/boat_conversion.htm. It fished great. Using the lodge boats would have made the trip less enjoyable.

     

    We averaged for 4 days on the Upper French and 1/2 day on the Lower French around 35 fish in the boat per day. Mostly smallmouth. I did have around a 40-45 inch muskie on fishing from shore below the Chaudiere Rapids when my brother and I walked around the dam on the trail. On 8 pound test, I was unable to keep is on more than 2 minutes in the rapids.

     

    We did have a mosquito problem in cabin 6. There was plenty of rain, with standing water under the cabins. If the mosquitos are factored out, it was very enjoyable. It is sad to see lodge owners struggle with the exchange rate.

     

    We have been going 2-3 times per year to Birch Island Resort in Minaki. Last year the lodge sold. Their business is way down this year. The change in ownership has been both positive and negative. We will go back next year but I am looking around.

     

    I have looked at Crow Rock on the web many times over the years and wondered how it was. My wife goes occasionally to Canada, but does not fish. She relaxes around the lodge, and occasionally goes with other women in to Kenora or the countryside for lunch and shopping. I suspect that will be difficult at Crow Rock. Do you think a non-fishing wife would enjoy relaxing at the lodge? Are the accommodations nice with indoor cabin plumbing etc? How is the main lodge? Anything else to do?

     

    I fish smallmouth primarily. How is smallmouth fishing on that section of LOTW? I see that the inland lakes are good, but just wondering about local smallmouth around the lodge.

     

    Thanks for your earlier detailed reply,

     

    Don

  9. Bigcreek,

    What lodge did you stay at on LOTW? We stay at Birch Island Resort in Minaki. It has changed hands. We also fish the Upper and Lower french. This year stayed at Casa Blanca Lodge on the Upper French. That is up for sale. Enjoyed our stay. We fished Crane's in 1990. Accomodations were nice, fishing so-so, but our skill level was not as good then. I am just perusing information on good lodges with good fishing, with American Plans and looking for recommendations.

    Don C

  10. TbayBoy,

    You are welcome. I fish them most of time here in TN and KY on KY Lake and Lake Barkley. I love them in Ontario and Michigan. I fish them in current and rapids also, reeling fast to keep up with the slack, giving a mild pull every 2-4 seconds. In slow current just pop the slack. Works great.

    Good luck fishing with them,

    Don

  11. I internally weight 3.5 inch Bass Pro tender tubes with 1/4 ounce tender tube jig heads. I use to use 1/8 ounce jig heads mainly, but find that I can work the tube faster with the heavier weight, and it works better in the wind. I leave around 1/8 inch of air in the tip, and do not run the jig head all the way in. The tube should come back nearly straight at you on a steady retrieve when testing the running of it. Running true like that will give a "walk-the-dog" back and forth motion underwater. If the tubes runs in circles, adjust the skirt on the hook, or pull off the offending misaligned skirt portions.

     

    I use 14 pound (or heavier), 12 inch fluorocarbon leader tied to a barrel swivel, to decrease pike/musky bite offs and decrease line twisting. I use stren 8 LB. hi-vis gold for the rest of the line. I "pop the slack" to give an irratic motion to the tube, with the rod held around the 10-11 o'clock position, going to the 1100-1200 o'clock position. I work it near or on the bottom. I crush barbs.

     

    If you hang up on rocks, open your bail (spinning), hold the line with one hand, pull back on the rod, and let the line pop off your grip. This will about 80% of the time pop the lure back off the rock.

     

    Colors are rootbeer, watermelon, shad, and whatever you have confidence in.

     

    Good luck,

    Don

  12. Four of the brothers have returned from the French River. We fished the Lower French on July 14 for 5 hours in the rain. We caught 22 smallmouth with about 4 pike that day. The largest smallmouth was 18 inches We then went to Casa Blanca Lodge and fished there the next 4 days. The food was better than the 4 star resorts I have stayed at. Unbelievable quality. There is a certifed chef cooking there.

     

    We did not catch a huge quanity of fish. We did a total boat count daily and were able to increase each day the total amount of fish caught. We ended up with 131 bass, mostly smallmouth, 24 pike, 12 rock bass, 3 drum (sheephead), 1 perch and 1 small musky. A total of 172 fish. We were pleased with the effort and results. I had a musky on in the Chaudiere rapids that was about 45 inches long, on 8 pound test with a tube, but could not hold it since I was on shore and could not walk it down the rapids due to high water release from the dam. We caught many smallmouth in the 15-18 inch range. The largest largemouth was full of eggs and 18 1/4 inches long. Caught a decent amount of largemouth in the large bay (m a r s h bay) on left across from the canoe channel. We fished about 4 hours for walleye in the evening, but caught none.

     

    We caught most of the bass on tender tubes with 1/4 ounce internally weighted jig heads on 8 pound test stren gold mono. We decided to just go down the back channel shore of the Upper French from Hunter's Bay heading to the dam on the last day. We caught 29 bass doing that. That evening we went out and fished the current on the islands across from the lodge and caught another 13 smallmouth, 6 rock bass and the small musky, around 20 inches. Musky was released without touching it, in the water. We fish with the barbs crushed down to cause less damage to the fish and make releasing the fish easy.

     

    Another great brothers trip.

     

    Hope all have great fishing and trips,

    Don

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