--> Getting It Right: The Leaders on Health Care

Thursday, December 08, 2005

The Leaders on Health Care

This week, veteran radio host Peter Warren asked each of the Federal leaders if they would access a private health provider if their wife was in great pain and had an 18 month wait for surgery.

Jack Layton said he wouldn’t – that he and his wife, fellow NDP candidate Olivia Chow, had talked it over and would stick it out in the government run system. I’d love to have been a fly on the wall for that Sunday morning kitchen table chat.

“So honey, I know that you can’t even move because you are in complete and utter agony, but I just cannot take you to England to see the world-famous specialist who could make this end. Your pain is such a small price to pay for respecting our over-burdened health care system.”

Stephen Harper, weighing his words carefully as a conservative must when discussing Canadian health care, told listeners that if there was truly no choice, no way to move up the wait list, and if his wife was suffering, he would do what he had to do for her.

Layton sacrifices Olivia for Canadian content points. Harper guarantees a friendly homecoming at the end of the campaign.

But what about Paul Martin, you ask. What was his response to this very difficult question?

After twisting a bit, he came up with this winner: the Canadian system isn’t in that bad of shape and if his wife was really suffering, she’d get in hospital immediately.

No kidding. His wife is married to the Prime Minister.

For the rest of us, I’m going to share some statistics. These all come from the Organization for Economic Cooperation and Development (OECD).

Canada spends more on health care than any other industrialized OECD country, save Iceland, when you adjust the data by age of the population. And given that people 65 and older consume 42.7% of the health care dollars, that adjustment makes sense. Even if you measure by straight, unadjusted percentage of GDP, we come 3rd in spending.

So, given that we spend more than any other country, one would hope that we get more for that money. Except we don’t.

On measures as diverse as number of doctors, access to high-tech devices like MRI machines, wait list time for surgery, and breast cancer mortality, we lag behind.

Canada’s infant mortality rate? We rank 16th out of the 23 countries measured. Our ranking for time with disability free life? We come in 14th. Doctors per 1000 population? Canada ranks 16th.

We’re spending a lot of money and just not getting the kind of health care we deserve.

We all have friends and family that have had to wait far too long for basic tests and services. Which makes me think it is very foolish of Jack Layton to blindly trust his wife’s health to this system.

And even more foolish that Paul Martin insists there is nothing wrong with our health care that another Liberal term in office can’t solve.

(As seen today in 24 Hours Daily)

26 Comments:

At 2:37 PM, Blogger PelaLusa said...

True, true, true! But as you know, most Canadians are in denial, denial, denial!! Why pay attention to facts when it's so much easier to go along with the narrative supplied by your friendly mind-numbing Kool-Aid provider?! This seems to be even more true of those in the GTA!! On Monday I'll be appearing on the radio, not in Toronto, but in nearby Hamilton and will pose this question to listeners: "What scandal would it take to get you to vote for someone other than the Liberals?"

Robert W.

 
At 8:57 PM, Blogger Canadi-anna said...

There is nothing wrong with our health care system if you're Paul Martin. Like you pointed out, what he said was true. He's so out of touch that he probably wouldn't realise that they were jumping the queue.
We'd be better off if Canadians started to realise that we already have two-tier health care. Once we admit it to ourselves, we can fix what's broken.

 
At 10:27 PM, Blogger redhead_pt said...

If someone could please respond to my post on "Conservatives are Canadian"...

 
At 1:15 AM, Anonymous Larry said...

It's better to have both public and private health care in Canada. Having private health care removes some of the burdens upon public health care also keeps the money in Canada. People who can afford private health care and want it for various reasons will go else where if it's not in Canada. Plus for a open and free market Canada should not keep high walls this helps create more employment and goods for Canadians. Again Conservatives are over the Fed-Liberals on this issue.

 
At 10:25 AM, Blogger Erin Airton said...

Redhead - I've responded below. Thanks! Erin

 
At 3:40 PM, Anonymous Peter said...

Hi, Erin,
Your columns are excellent, please don't feel discouraged with semantic or rhetoric remarks, specially when to justify the Liberals present corruption, the best they can do is to rehash what a Conservative Party, a party quite different from the present one, did more than a decade ago, a REAL fact you rightly did mention, amongst several others. The Conservatives were severely punished then. Common sense dictates the Liberals should suffer the same fate now.
Keep up the good work

 
At 5:43 PM, Anonymous Anonymous said...

You've touched on a sore point for this reader, so, in advance, I appreciate you and your readers' indulgence of my diatribe.

1.0 Canada Health Act
1.1 The federal political leadership, and some of its provincial couterparts, hold up the Canada Health Act as though it were the Bible (or the Koran, or the tome representing whatever deity to which one subscribes) and, frankly, it is not. It is a document that was crafted many years ago to provide for accessible, affordable and universal health care byway of a public sector insurer - full stop.

1.2 The bleeding hearts complain that they don't want a two tiered system - to those I say "wake up!" We have a two tiered system (I know - I've seen the benefits of the second tier (in the public system) in action and its great, but more importantly, under the current system the second tier is discreet and, the best part is that it is 'free').

1.3 If there were a parallel private system let's look at what it would achieve:

First, it would reduce the usurious waiting lists by the same amount as the number of those who choose the private pay route - result, those in the public system would get faster care.

Second, it would create tax revenue that otherwise would not exist (let's be truly Canadian and tax the pulp out of the private system) that could then be ear marked to go back into the public system - result, shorter lines, more funding.

Third, it would allow our talented surgeons to practice their trade more frequently than they are permitted in the public system - result, more skilled surgeons, fewer departures south of the border.

Currently BC has many private facilites (thirteen at my last count) that provide services to WCB, the penal system and provides care for medically unnecessary procedures. The facilites are cleaner. The staff are happier. The care is better (less rushed). The technology is leading edge. The equipment is newer. The accessibility is, well, uhm, accessible!

Am I missing something? Where is a parallel private system evil? Someone enlighten me!!

 
At 9:39 AM, Blogger Mitch said...

Since I moved to the U.S., I found out a lot about "US style" health care, and based on my own experience, find it to be excellent. Perhaps if it wasn't for the knee-jerk anti-americanism that is inculcated into the populace from a socialist public school system, people would be more open minded.

 
At 4:24 PM, Blogger redhead_pt said...

This comment has been removed by a blog administrator.

 
At 4:26 PM, Blogger redhead_pt said...

Peter, it was a grammatical remark, not one of semantics.
Canada has recently joined the ranks of the trillion dollar economic club.
So common sense actually dictates that 100 million wasted in AdScam is a drop in the bucket compared to more than 450 billion left by Mulroney's Conservatives. And since u appear to be so engrossed by the technicalities, that 100 million is a mere .022 percent of what Mulroney left behind. Adjusted for inflation, it's .017%. So, in recognition of this, can we all please stop dwelling on this trivial mismanagement of funds. Common sense also dictates that becasue Canada is a world leader in terms of it's economic performace (we rank first in the G8 by all indicies), the current Liberals have done more for our country than any party before them and only a fool would abandom them over 100 million dollars.

 
At 4:27 PM, Blogger redhead_pt said...

Sorry in advance for the lengthy comment, but there is much on this issue that need be said. I would like to start by saying that the US with it’s majority private medical system pays more per capita than Canada in terms of medical expenditures. And Erin, we actually come in seventh as of 2003 as a percentage of our GDP, behind the US, Germany, Switzerland, Iceland, Norway and France. Unless there were some data that I was not privy to, I’d say that you were clearly getting is wrong. See for yourself, if you like, http://www.oecd.org/dataoecd/16/9/34969633.pdf . I think this should show that private delivery is not inherently better as you would have us believe. Though I am a self-professed Liberal, I do not think the public system is without fault. Nor do I think current Liberal policy portrays perfection within the system. Paul Martin is currently looking for “creative” ways to deal with the problem, as evidenced by his refusal to crack down on budding private health care establishments. But the problems faced within a two-tier system would go well beyond those currently experienced.

For one, we already face a shortage of trained medical personnel. This doctor shortage would only be exacerbated as doctors would flock to better paying posts in the parallel private system. We would be left, then, with a system wherein people pay for better and more timely service, which disregards the inherent equality of the public system. As the OECD study on income distribution of medical care shows “[Canada] does seem to achieve an equitable distribution of its care.” This is something that we should work to maintain.

Also, I question how any of you would rationalize the “shorter” wait times for the people not served by the private system. Sure, there may be fewer people in line, but since there would be fewer doctors to serve them, the wait time would be, if anything, lengthened. My problem then comes down to equal opportunity- that all Canadians should be entitled to treatment of the same caliber. The rich alone should not be left to reap the benefits of our highly skilled practitioners, least of all when their medical schooling is delivered with funds from the public purse.

Again the result of overburdening Conservative-administered debt, the Liberals were forced to slash federal spending through the 90’s. Health-care took the largest single cut, and Canada was among the only countries whose per capita medical personnel actually decreased, hence the longer wait-lists. Now that our economy has fully recovered, we need specifically targeted reinvestment, so that this alarming trend might be reversed. We need to fund programs aimed at fast tracking foreign trained doctors so that they may practice in Canada more quickly. We also need to fund advanced education, particularly that of medical schools. I am not calling for a decrease in tuition, simply an increase in the number of medical school seats, all of which can be attained at minimal cost.

Also, we need to stress the benefits of preventative care. Healthy eating habits and exercise are essential for good overall health. With obesity on the rise, this has never been closer to the truth. I propose that the government allow sporting fees and exercise equipment to be tax-deductible, thereby providing a financial incentive for their use.

As I have admitted our system is not working. But a parallel private system, for the above noted reasons, is not the answer. What would be a workable solution , in my view, is to allow for a quota system, whereby those willing to pay could pay for their services at up to 10% of weekly hospital delivery. Doing this would not take away from the equality in access to the average person, and would also recoup some losses from the cash-starved public system. Also, there needs to be more of a push for a stream-lined medical system- that is, reducing the inefficiency created by endless levels of bureaucracy, which I’m sure represents a large share of our health care spending. It is this kind of creative innovation that is necessary in dealing with our problem-riddled system, not the reflexive jump to private care.

 
At 10:17 PM, Anonymous Anonymous said...

To readhead's comments:

"This doctor shortage would only be exacerbated as doctors would flock to better paying posts in the parallel private system"

- they already do!! They eiter operate in our private system or go to any of the other developed countries to operate and practice their trade.
- notwithstanding the forgoing bullet - this 'problem' can be solved by requiring, as a condition of being permitted into the private system, those surgeons choosing to operate in the private system to maintain a minimum percentage of their operating time in the public system.

" question how any of you would rationalize the “shorter” wait times for the people not served by the private system. Sure, there may be fewer people in line, but since there would be fewer doctors to serve them, the wait time would be, if anything, lengthened."

- there wouldn't be fewer doctors...as I stated, provide that as a condition of operating in the private system, doctors could be required to maintain a certain percentage of their time in the public system (in fact, given that surgeons are terribly underutilized now (not theory here, but factual reality) one could probably require them to maintain their status quo insofar as operating time the public system is concerned, and permit them to use the balance of their time in the private system).

"My problem then comes down to equal opportunity- that all Canadians should be entitled to treatment of the same caliber. "

- wake up!! This occurs now, except it's very quiet and, best of all, its free. Sort of like the MST was before RH Brian Mulroney brought in the much needed GST. He was villified, but he took a hidden tax that, as such, could be manipulated upward and downward without you and me, joe public, knowing. He replaced it with a very visible tax that couldn't be raised without much consternation. Similarily, the 'second tier' exists in our current 'equal, accessible and 'free' system'. The amazing thing is that the current system isn't equal, it isn't accessible and, indeed, it is not 'free'.

"Now that our economy has fully recovered, we need specifically targeted reinvestment, so that this alarming trend might be reversed. We need to fund programs aimed at fast tracking foreign trained doctors so that they may practice in Canada more quickly."

- you're about 3 or 4 years late in your commentary. Pouring more cash or, as you put it, 'reinvesting' in health care is not going to improve it. How the current budget is spent will. Added efficiencies and better technology is what is needed.

"and Canada was among the only countries whose per capita medical personnel actually decreased"

- oh yeah, this is a grrreat reason to increase spending. Hmm, our per capita spending is going down, wait lists are going up, so let's not look at how the money is spent, let's just look at how much is being spent. A is friends with B, B is friends with C so, therefore, A must be friends with C. Really deep analysis redhead.
- let's say your analysis proved out and we just needed to pour more money into the system, don't you think the HEU would be all over the increased allotment claiming their 'workers' rights to be treated fairly' (since when is a janitor getting paid more than a teacher fair, but alas this opens a whole other can of worms)

"that is, reducing the inefficiency created by endless levels of bureaucracy, which I’m sure represents a large share of our health care spending."

- I couldn't agree with you more!

"It is this kind of creative innovation that is necessary in dealing with our problem-riddled system, not the reflexive jump to private care.."

- firstly, when we arrive at a suitable parallel private system (yes I said 'when' not 'if') it will, indeed, not at all be reflexive. There has been much thought put into this matter by some very bright people. We have the benefit of looking at other private systems and the opportunity to take the good and leave the bad.
- secondly, you'd be amazed at how innovative the private sector can be (have you ever spent any time in the private system that exists now? can you speak with any real experience or expertise?).

 
At 11:59 PM, Blogger redhead_pt said...

“this 'problem' can be solved by requiring, as a condition of being permitted into the private system, those surgeons choosing to operate in the private system to maintain a minimum percentage of their operating time in the public system”

So, in effect, having a quota minimum for doctors’ time spent in public practice? I do like the idea, although it is not all too different from that which I had proposed.

“you're about 3 or 4 years late in your commentary. Pouring more cash or, as you put it, 'reinvesting' in health care is not going to improve it. How the current budget is spent will. Added efficiencies and better technology is what is needed… oh yeah, this is a grrreat reason to increase spending. Hmm, our per capita spending is going down, wait lists are going up, so let's not look at how the money is spent, let's just look at how much is being spent. A is friends with B, B is friends with C so, therefore, A must be friends with C. Really deep analysis redhead.”

Better technology is what is needed? And how do you expect that to materialize without any further investment??? Not only did I go on to say that efficiency was needed, but you fail to acknowledge the target of said reinvestment- or cash pouring as you so eloquently put it. I specifically would like to increase per capita doctor levels to at least OECD averages. As it now stands, we are below those levels, at 2.1 doctors per 1000, where the average is 2.9. Making use of skilled practitioners already in Canada is far faster, cheaper, and of greater economic benefit than funding the full training of all new doctors in our overcrowded med schools.

“let's say your analysis proved out and we just needed to pour more money into the system, don't you think the HEU would be all over the increased allotment claiming their 'workers' rights to be treated fairly' (since when is a janitor getting paid more than a teacher fair, but alas this opens a whole other can of worms)”

This is one can of worms over which we are in agreement. I, too, think that certain positions within the hospital setting are not worth their compensation in this over-unionized country.

Thus, we are left with very few differences in our fundamental beliefs concerning the medical system. What then, drives you to vote Conservative whilst my allegiance is with the Liberals?

 
At 9:25 AM, Anonymous Anonymous said...

- yes the minimum % of time is what I am suggesting. I go further to suggest that, if we had a private system wherein doctors could actually practice their trade; and actually allowed foreign doctors to challenge our fellowship examinations (thereby permitting them to practice) we would have an instant improvement of the doctor:patient ratio.

- overcrowded med schools? Where do you get this information? How is overcrowded defined?

- I don't think pouring more money into the public system as 'reinvestment' would increase technology or innovation. Pouring this cash into the hands of innumerable "directors", "managers", "administrators" to develop more "strategic plans", "PowerPoint Presentations", and to host "retreats" so that the fat infrastructure can justify its very existence would not help patients get better care.

I liken the health care system to an aircraft carrier: the 'system' is the crew on the deck of the carrier and the doctors are the fighter plane pilots. The deck crew has one purpose and one purpose only - to ensure that the pilots can take off and land safely. Similarly, the 'system' should have one purpose and one purpose only, to allow doctors to care for their patients in the best way possible. The 'system' has proven that, in its current form, it cannot do this.

- let the private sector in, let the very viability of an organization rest on its ability to care for patients in a timely, safe, effective and comfortable way. Remove entitlement from administration. Creat incentives for better care and best practices.

-Hmm, why vote conservative. One word - integrity.

Warren Kinsella put it very well in his book, "Kicking A** In Canadian Politics" when he said the Liberals have the strongest ideology of all the federal parties. What is that ideology?

POWER!

I stand for more than that.

I stand for fiscal prudence (I have been pleased to see the Liberals keep most of Mulroney's policies, including the important, but much maligned, GST)

I stand for open trade borders.

I stand for productive, positive, courteous relationships with my neighbours.

I stand for a Canadian identity that is more than "I'm not American" and I'm everything else first and Canadian second.

I expect honesty from my political leadership.

I expect low taxes and a fiscally prudent government.

I expect expedient, effective, world class health care. I expect to pay for my health care.

I expect a strong, world class military.

 
At 9:29 AM, Anonymous Terry Brenan said...

In 95 I moved from Calgary to Aldergrove, my Calgary doctor refered me to a Vancouver specialist, one and a half years for an appointment and then 2 years for the surgery, (nasal polyps) I called my doctor back in Calgery,made an appointment, returned the next week, paid a clinic $300.00 had the surgery and came back to BC. Am I a fan of user pay----you bet. I have recently had an occasion to work in Alberta and participate in their health system, miles apart from the Vancouver model, there may be nothing wrong with the basic system here, just how it is administered.

 
At 5:36 AM, Anonymous Anonymous said...

I usually don't correct other people's language, I am more interested on the contents of their message, but when someone corrects me I reply: Webster's says:
se[man[tics (tiks)
1-the branch of linguistics concerned with the nature, the structure, and the development and changes of the meanings of speech forms, or with contextual meaning
rhetoric
2.[Grandiloquence] — bombast, high-flown language, empty talk;
I wouldn't call the Liberal corruption scandal a "technicality", and that is just what has surfaced up to now, which together with the Gun Registry and several other recent "Liberal technicalities" is what dictates that the Liberal Party should have a "long holiday" from government.I am concerned with the present and 13 years is a "long present" to base my decision on.

 
At 6:56 PM, Blogger redhead_pt said...

How I enjoy when one takes it upon himself to construct meanings for words all his own. Since you felt the need to reply, I would have appreciated it had said reply had at least been well-reasoned. I know the meaning of the word, thank you, so you really needn't demonstrate your lacking proficiency with the English language. The actual Webster’s definition is far from the one you provided, so spare me the BS about being a grandiloquent pedant. If you take note, I was specifically referring to the use of quotation marks in the original post, hardly a semantic remark- the comment was of purely grammatical grounds. It is inevitable that certain politicians will succumb to their greed and become corrupt. Such is the nature of power. All I mean to say is that its scope is trivial when compared to the misdoings of past governments. And would that “present” be any more bearable even if it were 5 years? 3? 1? Unlikely. The liberal party most always goes by way of the majority, progressive in their direction, conservative in their administration thereof.

 
At 7:30 PM, Blogger redhead_pt said...

“overcrowded med schools? Where do you get this information? How is overcrowded defined?”
Excuse my wording. I do not mean to say that med schools are overcrowded, but I would say that they are not big enough to accommodate the growing demand for doctors.

“- let the private sector in, let the very viability of an organization rest on its ability to care for patients in a timely, safe, effective and comfortable way. Remove entitlement from administration. Creat incentives for better care and best practices.”
I simply don’t see why you think it better to have individuals profiting in a parallel private system. Why not have the semi-privatized public system of which I speak, whereby weekly quotas allow paying individuals to get the timely service they seek. In doing this, their money goes back into the system rather than into someone’s bank account at the end of the day.

“I stand for fiscal prudence”
The liberals have shown overwhelming fiscal responsibility over the length of their tenure. And because the majority of Canadians are in support of our social safety net, they are not at all unimpressed by Liberal spending to date.

“I stand for open trade borders”
Check. It could be easily argued that the US, a Conservative stronghold, has become far more protectionist that Canada.

“I stand for productive, positive, courteous relationships with my neighbours.”
Do not mistake this for submission and bowing to their every whim. In recognizing our sovereignty, we have a duty to stand up for what we believe.

Canadians typically suffer from “second best syndrome” in their attitudes towards America, which, although it is perfectly understandable, is not the entirety of the Canadian identity.

Our taxes are low, compared to such jurisdictions as the European Union. It’s all relative, and very much a necessity if we expect to spend on social programs like we do.

“I expect expedient, effective, world class health care. I expect to pay for my health care.”
Do you expect everyone to pay for their health care? Payment is beyond the reach of many individuals, and a fully privatized system forces government to pay more, not less. Look at our Southerly neighbour, who has the highest allotment of GDP toward medical expenditures of all OECD countries. Stop being so selfish; recognize that in the grand scheme of things, we have world class medical system. We are the envy of 100 and some-odd developing nations, who can only wish to be in our position.

“I expect a strong, world class military.”
This is not the middle ages, where kingdoms spar for supremacy. What good is a strong military in today’s world? This is the remnant mindset of the testosterone raging male whose taste for power is unquenchable. I can only hope that are now beyond that… errr… will be when Bush and his neo-con puppeteers leave the ring.

 
At 7:33 PM, Blogger redhead_pt said...

Let me also add that paying down our debt at the current rate will leave room for tax cuts. Nobody said it would be easy mopping up Mulroney's mess.

 
At 9:15 PM, Anonymous Peter said...

My comment shouldn't having been posted as anonymous, I must have clicked it by mistake.
Like all your "long lectures" above, you are wrong once again, the quotes were "cut and paste" from the Websters CD, I did not "construct" any meanings, the "rhetoric" I did paste is the second one given, minus the insulting meanings. Far from me "lecturing" anyone on the English language, you were the one correcting Erin. I just did point out to her to ignore such "corrections".
I am giving up getting involved in further discussion. I though this was a Conservative site where I could read common sense comments, instead it appears to have been taken over by the usual liberal "mantras" of which I get more than enough on the main media.

 
At 8:11 PM, Blogger redhead_pt said...

There is no such thing as objective common sense. Common sense is merely one’s own mental construct, usually based on logically sound reasoning… and then there are people like you. I am free to correct anybody’s inappropriate use of our mother tongue, especially when it is used in the defamation of our government. I am but one person among the many who have been posting, and if you find my being here so unbearable, I’ll take it as testament to the irrefutability of my arguments. There is nothing wrong with debate. It is the substance that solidifies what strong arguments you may have, and through cognitive dissonance, allows expansion of your narrow-minded ideologies. If you so please, leave. Yet another Conservative ignoramus who will not be missed.

 
At 12:41 PM, Blogger Erin Airton said...

Gentlemen- let's keep the debate from becoming a personal smearing fest.

And, Redhead, believing in a strong military and a traditional definition of marriage are not "narrow-minded ideologies", but rather values that most Canadians hold dear.

Also, I would highly suggest all review the parallel and user-pay systems in Europe. There are options that should be openly debated.

Finally, if anyone gets chased off this site, I will be doing the chasing - and trust me, the visual of me with a rolling pin is not pretty.

Peter please stick around. I know it is frustrating at times, but I know that you have the grace to perservere.

Merry Christmas,
E

 
At 4:11 PM, Anonymous Peter said...

Hi Erin,
Thanks for your comments. I will stick around to read your comments and other common sense ones.
I know now which Rants to by-pass with a scroll.
Merry Christmas
Peter

 
At 5:17 PM, Blogger redhead_pt said...

I will ask yet again, since you all seem hesitant (or unable) to come to a response. What would heterosexuals lose in granting same-sex couples the right to marriage? Bill C-38 has clauses for the protection of religious freedom. To be so pig-headed in protecting the traditional definition with the sole rationale of “it’s mine” is nothing less than a distasteful show of homophobia and discriminatory views. Marriage has always been about love and sexuality. What marriage have you ever been to where the vows exchanged had not some mention of love? There are legal rights associated with marriage, and it is very much a governmental affair. It is government that issues marriage certificates, not the churches. Churches have every right to deny marriage to same-sex couples, but many churches in this country are very progressive and accepting on this issue. As is most of the populus, for that matter!

“believing in a strong military and a traditional definition of marriage are not "narrow-minded ideologies", but rather values that most Canadians hold dear”
Most??? Ha! Misrepresenting the facts yet again Erin- it is becoming quite the habitual blunder on your part. Since you appear to have missed it, I had posted a link to study that outlines the stats. Some highlights: 53% of Canadians support same-sex marriage, and the numbers are skewed by age brackets. “70% of 18-24 years olds support same sex marriage, compared to only 32% of those over 55.” So as the years go on, and when the conservative seniors of an older era are no longer around, support can only rise. We need laws that reflect the times. So, either get with the program, or get out of the debate. This issue has long been put to rest, and there is no sense now in reviving it.

 
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