--> Getting It Right: Public Health Care on the Skids

Thursday, February 01, 2007

Public Health Care on the Skids

Not surprisingly, health care in BC is on the front burner again.

If you are shocked by the machinations in the Vancouver Coastal and Fraser Valley Health Authorities, you shouldn’t be.

Simply put, our health care system doesn’t work.

We are like a family living in a neighbourhood far beyond our means and buying our groceries on a maxed-out credit card.

Anyone who has lived with a stretched budget knows sooner or later the elastic is going to snap.

Throwing more money at this problem isn’t going to solve anything, other than forestall the inevitable for another election cycle.

Health spending in BC has increased over 25% since 2001 and spending alone this year will increase over 7%, with the pre-budget announcement from the Health Minister last week. In raw numbers, the Ministry of Health will spend $13.1 billion in this fiscal year, including a $100 million for a Health Innovation Fund.

Health care spending accounts for 42% of our provincial budget. Some projections have it at 70% by 2017.

If almost half of your household expenses were taken up with one item, you might feel some pressure to get innovative on spending.

You might choose not to participate in some activities, or sell your car, or not eat out very often. Maybe you would get a roommate. Perhaps you would even have to move to a less expensive city.

What many find frustrating about this situation, which exists across Canada, is the unwillingness of governments to consider innovative solutions because of fear of a vicious lashing from voters who have bought into the mythology of public health care.

Public sector unions, among other vested interests, are threatened by public/private mixed health care, although they operate in many European countries relatively successfully. They point to the U.S. and tell us that is what we’d get with health care reform. How ridiculous. Why don’t they reference Germany or Norway?

Why not consider that our grocery stores are all privately run. No one is starving in our country because of private grocery stores. In fact, due to the competition and efficiencies of the private sector, we have the opposite problem: an abundance of cheap food. We get flyers in the mail every week encouraging us to visit a new grocery store and check out the bargains.

Thankfully, no one is suggesting that governments should run the grocery stores. Or book stores. Or Laundromats.

So how is it we believe that health care is the only part of society for which market economics don’t apply, against overwhelming evidence to the contrary?

There is no doubt we will have to reform our precarious health care system. Let’s start now, rather than wait for the creditors to start pounding on the door.

As seen today in 24 Hours


At 12:29 PM, Blogger Robert W. said...


The biggest problem of all is that public hospitals have absolutely no idea how much a given procedure costs. With any organization, if one doesn't know the costs then it's impossible to control the spending.

During the last federal election I was on-air with the healthcare minister at the time, Ujjal Dosanjh. I asked him point blank why the costs could not be determined. He responded that it was "absolutely impossible" for anyone to know this.

Several months later I had the same discussion with a woman who had been a senior bureaucrat in Paul Martin's gov't. She stated that it would "cost several million dollars to put in place a software management system to track such costs".

Soooooo? We're spending countless billions of dollars every month on healthcare. What could possibly be wrong with spending a tiny fraction of that to better manage the whole?

Every single private company in the world has software systems in place to help them track what they need to, so as to effectively run their operations. Such software is not "new" or "novel". Why then is it impossible for public healthcare to do the same?

The answer, of course, gets back to your comment about vested interests. I'm convinced that NO ONE in public health care wants the costs of individual hospitals to become known. For if they did, they'd undoubtedly find huge discrepancies in costs between one hospital and another.

This would ... wait for it ... actually make people accountable. But we couldn't have that, could we?!

Robert W.

At 1:15 PM, Anonymous Anonymous said...

I've worked for health authorities and the ministry of health in BC as a contractor and I have seen where all that money goes. Next time you take a dump you might see it as you flush.

At 6:08 PM, Blogger David Berner said...

Hi Erin,

Thanks for your thoughtful essays on important matters of Public Policy.

The radio show to which robert w. referred in an earlier comment herein was my former show on CKNW.

Like you, I am these days a mad blogger, and I will ahppily add your site to my links.

My own piece on health care, posted last Saturday, can be found at:

Best wishes,

David Berner

At 9:26 PM, Blogger Walter Schultz said...

If money was the solution to our health care problems we would have solved the problem years ago.

We are never going to stop people from dying. We are all going to die eventually.

Nearly two-thirds of all health-care dollars spent on us during our lifetimes is spent during the last six months of our lives (mid-1990s data). Much of this "health care" falls into the category of 11th hour heroics poorly supported by objective medical judgment and family members guilt or fundamentalist religious beliefs.

If just a quarter of late-in-life (last 6 months) health care costs can be eliminated we could reduce BC's health care costs by over $2 billion.

Political issues have largely prevented pursuing this issue in the past. But as health-care costs grow to ever-larger fractions of the GDP, and as the futility of the stop-gap measures of government increased funding become ever clearer, frustrations and anger will mount, and the tide will likely turn.

At 12:08 PM, Anonymous Stephen Rees said...

you wrote:

Why not consider that our grocery stores are all privately run. No one is starving in our country because of private grocery stores. In fact, due to the competition and efficiencies of the private sector, we have the opposite problem: an abundance of cheap food.

But you may have noticed that there are increasing numbers of people who rely on food banks. Now that is not the fault of Safeway. of course. But the idea that no one is starving because of the success of the private sector is nonsense. In fact people are starving and homeless and not being treated effectively by the healthcare system. And private sector solutions mainly designed to enrich the providers. In fact I have also seen it argued that the social services (such as they are) only exist to employ social workers.

We need the public sector to do those things that the private sector cannot be trusted to do. In most cases public enterprises were set up to cope with market failures or monopolies. So ok, you go with private sector provision if you like, but be prepared to provide some effective public sector oversight.

And you might want to check some of these other comments as they seem to be to be blogspam


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