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It seems that there is a great deal of disappointment in how managed health
care in the US has been operating, and I have a few comments to make
regarding the subject.

First, I am a Canadian and have only been living in the US for a few months
and have not yet had occaison to use any aspect of my company health care
plan, so I have no idea what the situation here is like. In Canada we have
the ultimate in managed care, a government run health care system with free
access to all, assuming you pay taxes. There are problems with the system,
and there have been cutbacks in many areas recently, but comparing our
complaints to those I have read/heard about in the US, the Canadian system
works very well. I have never had a doctor refuse to do a test for
financial reasons, and as far as I know there is no "punishment" for a
doctor who does a lot of tests. I have had doctors tell me that they must
"justify" certain tests, and I know for certain that they can't do biopsies
looking for celiac disease without a pretty good reason. There are no
insurance companies involved, although recently there has been talk of
getting them involved to remove some of the financial burden from the tax
system.

I know that there is a philosophical aversion in the US to the Canadian
socialized approach to health care, but I think it is a great system. I am
in the process of trying to find a GP in the Boston area, and my PPO
"preferred" list has only one physician in my town signed up! If I go
outside of my PPO, then I have to pay 20% of my health care costs. In
Canada I could go to any doctor I chose and never had a single
out-of-pocket expense (except during the time I was living in Quebec, but
that is another story).

I wish I could say that I had more experience with the US managed care
system so that I could better compare it to the Canadian system. Perhaps it
isn't managed care itself that is at fault, but rather the type of managed
care system that is causing so many problems?

I would appreciate hearing any thoughts that other list members have to
offer on this subject, I think it is an important one.

Elise Gorseth
Assistant Scientist
SCRIPTGEN Pharmaceuticals Inc.
200 Boston Avenue, Suite 3000
Medford, MA 02155

Tel: (617) 393-8041
Fax: (617) 396-1028
E-mail: [log in to unmask]