34 replies to this topic

[August1991]

Nice to see parliament actually working for a change.

It's a lot easier to come to agreements when you're discussing things for the benefit of Canadians rather than just trying to make each other look bad.

Huh?

Health care is a provincial jurisdiction. There is no federal department of education. Why is there a federal health department?

I suspect that Aglukkaq is simply repeating Harper's line here. (Call it a firewall.) The federal government favours good health care for all because health is a provincial issue.

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The far more important question is to ask why we have drug shortages. Well, why do millions of Canadians lack a family doctor? In short, our provincial governments have chosen Soviet health systems. And now we have shortages.

What will happen next in Canada's health system? Since we have adopted the Soviet model, after shortages the next step is bribery. So, I'd say that Canadian doctors/hospital administrators will enjoy good all-expense-paid trips to Florida condos.

Edited by August1991, 15 March 2012 - 08:58 PM.

[Smallc]

Health care is a provincial jurisdiction. There is no federal department of education. Why is there a federal health department?

Because there are certain health related matters that require federal regulation because of jurisdiction. Health Canada doesn't really deliver health care.

[cybercoma]

Because there are certain health related matters that require federal regulation because of jurisdiction. Health Canada doesn't really deliver health care.

Delivery is generally considered private with a public single-payer.

[cybercoma]

Article from 2002. Highlight mine:

Delivering Health Care Services: Public, Not-For-Profit, or Private?

Highlights
· How care is financed is not the same as how it is delivered.

· “Private delivery” is not a homogeneous category. Private providers can be not- for-profit
(NFP) or for-profit (FP); in turn, for-profit includes a range from small businesses (FP/s),
such as physicians’ offices, to corporate organizations which are expected to provide returns
on investment to their shareholders (FP/c). The characteristics, and implications, of these
different types of organizations vary considerably.

· In Canada, most health care delivery is already private. Although about 70% of Canadian
health care is financed publicly, almost all of this care is already delivered by private (usually
NFP) providers.

· Comparing public, NFP, and FP delivery is complicated because they usually do not offer the
same services. Because they need to make a profit, FP organizations will tend to serve
potentially profitable services and client groups. Many attempts to compare costs or
outcomes are, in effect, comparing “apples to oranges.”

· The desirability of encouraging FP delivery depends upon how such firms make their profits.
Potential ‘win-win’ situations exist if savings result from strong economies of scale
(especially for services which can span jurisdictional boundaries) or better management.
However, savings frequently arise from more contentious measures, including freedom from
labour agreements (and different wage levels and skill mixes), evasion of cost controls placed
on other providers, sacrifice of difficult-to- measure intangibles, risk selection/cream
skimming, or even dubious practices.

· When services are delivered privately, it is necessary to monitor performance. Such
monitoring is often costly and difficult; these costs must be included in any fair comparison
of alternative delivery approaches.

· Performance monitoring is more likely to work for services whose outcomes are easy to
measure; however, many health care services are too complex to be treated in this way.

· If performance cannot easily be monitored, NFP delivery is more likely to provide high
quality outcomes than is FP delivery, with FP/c being the most vulnerable to poor outcomes.

· To the extent that economic advantages arise from private delivery, the literature suggests
these derive more from the imposition of competition than from ownership type.

You can read the whole article here: http://publications....79-17-2002E.pdf

[August1991]

Smallc and cybercoma, you have avoided the greater question: Why do Canadians suffer shortages when seeking health care?

Why do millions of Canadians have no family doctor? Why must Canadians wait for weeks or months before a health appointment? Why do Canadians accept that a trip to an emergency room means several hours of sitting?

Has the NDP/PQ/Liberal made State health care the new Catholic Church? Is this now the Canadian religion?

Should we all wait for a priest to be free before we can confess?

Edited by August1991, 15 March 2012 - 10:06 PM.

[cybercoma]

Because everyone should pay out-of-pocket for healthcare. Delivery would be so much better if people could just pay out-of-pocket, instead of having to use the single-payer system.

That's what you want to hear, right?

Edited by cybercoma, 15 March 2012 - 10:07 PM.

[August1991]

Because everyone should pay out-of-pocket for healthcare. Delivery would be so much better if people could just pay out-of-pocket, instead of having to use the single-payer system.

That's what you want to hear, right?

No, that's not what I'm saying.

I'm simply saying that your idea of health care is Soviet. It's not sustainable. Eventually, it doesn't work.

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Millions of Canadians, 50 years after Tommy Douglas and the Canada Health Act, will attest to my opinions. We all know it doesn't work.

Edited by August1991, 15 March 2012 - 10:22 PM.

[cybercoma]

No, that's not what I'm saying.

I'm simply saying that your idea of health care is Soviet. It's not sustainable. Eventually, it doesn't work.

What's my idea of healthcare?

[August1991]

What's my idea of healthcare?

Single payer with union monopoly. Am I wrong?

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Cybercoma, you miss my point. The current Canadian model is not sustainable. Harper intends to let provinces figure out what to do.

I think Harper is right. And he has the Constitution on his side.

Edited by August1991, 15 March 2012 - 10:33 PM.

[cybercoma]

Single payer with union monopoly. Am I wrong?

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Cybercoma, you miss my point. The current Canadian model is not sustainable. Harper intends to let provinces figure out what to do.

I think Harper is right. And he has the Constitution on his side.

No. Your point was clear. You said Soviet-style. Did the Soviets have a publically-funded and privately-delivered healthcare system?

[Bryan]

Why do millions of Canadians have no family doctor?

Because most of them haven't bothered to really look for one. There are more doctors in Canada now than there have ever been.

Why must Canadians wait for weeks or months before a health appointment?

They don't have to. I can get in to see my doctor within a day. I can get x-rays the same day, I got an MRI within 6 days a few months back.

Why do Canadians accept that a trip to an emergency room means several hours of sitting?

Because they go there when they don't have an emergency.

[Evening Star]

They don't have to. I can get in to see my doctor within a day. I can get x-rays the same day, I got an MRI within 6 days a few months back.

Yeah, I don't get that one either. I've never had to wait months for a regular doctor's appointment. (To see a specialist, maybe.) If my doctor is booked for the day and I really need to see someone, I can always go to a walk-in clinic and be seen within a couple of hours (an option I didn't have in the US, by the way.)

And ER visits can mean several hours of sitting in the US as well.

[fellowtraveller]

In Canada, most health care delivery is already private. Although about 70% of Canadian
health care is financed publicly, almost all of this care is already delivered by private (usually
NFP) providers.

I don't understand how 'almost all of this care is delivered by not-for-profit providers'.

Much is delivered by doctors and their staff. They are most certainly 'for profit' providers, they don't work as a charity.

[August1991]

No. Your point was clear. You said Soviet-style. Did the Soviets have a publically-funded and privately-delivered healthcare system?

They had a publicly-funded and largely not-for-profit delivery system. So, yes. The Canadian system was similar to the Soviet system with central edicts (Canada Health Act). Moreover, each Soviet republic (there were 15) interpreted this in different ways - just like in Canada where bureaucrats in 10 provincial ministries interpret these rules in different ways.

Heck, for good measure, let me throw in the CPSU (Communist Party) members who worked in the ministries/hospitals/health centres. They were like our union activists.

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Cybercoma, the Soviet Union survived for about 70 years or so and I reckon that our health system will have a similar life expectancy. Like the Soviet Union in the 1970s, our health system at present has extensive shortages obvious to all, politicians (advised by bureaucrats) who talk of "tinkering/more resources" and apologists who blame the problem on "saboteurs" in the Soviet Union or "neo-con/private sector" in Canada.

Bureaucrats - like engineers - love to tinker. But bureaucrats always want more resources.

Canada's health system is Soviet, and I suspect that it will have a similar end - in about 10-15 years or so.

Edited by August1991, 17 March 2012 - 11:51 PM.

[August1991]

Because most of them haven't bothered to really look for one. There are more doctors in Canada now than there have ever been.

Huh? Bryan, you sound like Leonid Brezhnev.

According to "your" statistics, there may be more doctors. But according to "official" statistics, Canadians can't find them.

In 2010, 4.4 million people, or 15% of the population aged 12 and older, reported that they did not have a regular medical doctor.

Correction: More than one quarter of those aged 20 to 34 (27%) were without a regular medical doctor, a percentage steadily declining as age increases. In comparison, nearly 1 in 5 Canadians aged 35 to 44 (18%) and 5% of seniors 65 years old and over were without a regular medical doctor.

In 2010, as in previous years, men were generally more likely than women to report being without a regular doctor.

Of the 4.4 million Canadians without a regular medical doctor in 2010, more than 8 in 10 (82%) reported that they had a usual place to go when they needed medical care or health advice. A majority (62%) reported using a walk-in clinic, while another 13% visited a hospital emergency room.

Correction: In 2010, as in previous years, just over half of those without a regular medical doctor (53%) had tried unsuccessfully to find one. Among these, 40% said that doctors in their area were not taking new patients, 31% said that their doctor had retired or left the area and 27% said that no doctors were available in their area.

Statistics Canada 2010

Bryan, how old are you? Do you live in a large city, or in a rural town?

In 1970 (heck, in 1950), how many Canadians were without access to a family doctor - someone that they had known for many years? Was it "more than one quarter of those aged 20 to 34 (27%) without a regular medical doctor, a percentage steadily declining as age increases"?

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The Soviet Union also had a statistical service that presented similar arguments in defence of the status quo.

Fortunately, we have glasnost.

Glasnost? Consider this random 2011 CBC article. (Note that comments were closed after 9 made.)

And note this phrase in the CBC report:

It's the first time the agency has opened new positions based on geographical need, but Ackaoui said some areas are a hard sell.

Two typical Soviet bureaucratic phrases to explain a shortage: "agency" and "geographical need".

Edited by August1991, 18 March 2012 - 12:34 AM.