Issues that matter - Health Care

[Argus]

The economy is certainly important, but I question the ability of any of the political leaders to do much about it since the influences seem to be mostly external. Health care, on the other hand, is certainly something that needs to be addressed. A few billion tossed into the health care kitty has dulled the howls to a dull roar, but the system continues to have major problems which are only getting worse as the population ages. A recent study puts Canada's health care system wait times in last place among 29 nations studied. Who is going to do anything about that? I've heard nothing from the Liberals on this but mouth noises. The NDP, true to their usual manner, want to throw money at it - which means raising taxes. Now I'm not against raising taxes and throwing money at an issue if it will actually solve the problem but I doubt that will be the case.

Obviously the Tories are limited in what they can say here. The NDP and Libs are eager to pounce on any hint of a suggestion of an opening that will let them accuse the Tories of wanting to institute an "AMERICAN" style system. But it isn't clear they have any ideas for tackling the problem, nor that they're even working on it.

Because to them, any changes to the Canada Health Act constitute an AMERICAN style system.

But the fact is there are three basic systems at work in the civilized world. There is the American system - which no one has chosen to imitate. There is the system of 100% public ownership which Canada, North Korea, and Cuba embrace. And there is a mixed system which everyone else uses. Oddly, none of those other countries, such as the Swedes or Fins or Japanese or Danes or French or Germans, have seen the beauty and wisdom of the system used by us and the North Koreans and chosen to embrace it. I wonder if that might not be a clue to people. We need to use language like that to tear stilted minds away from the idea - long cultivated by the Liberals and NDP - that the alternative to what we have is the idiocy of the American system.

What I'd like to see is Harper announcing that within one week of his election with a majority government he will appoint a panel - a small one, no more than three or four experts, to study the best systems in Europe, particularly the nordic countries, and perhaps France and Germany, and redesign our health care system by taking the best aspects of theirs. They'll have one year to make their report, and then the government will begin to act on it.

If he specifically names European nations with good quality public health care it would be very hard for the Liberals and NDP to twist that into a "Harper wants a US style system!!!!". And I think Canadians really want to see some leadership on this issue.

[Smallc]

But the fact is there are three basic systems at work in the civilized world. There is the American system - which no one has chosen to imitate. There is the system of 100% public ownership which Canada, North Korea, and Cuba embrace.

Cuban system works quite well, just lacks technology. If we had the number of doctors per person that they do, there would be no problem. That is the real problem in most cases, lack of people. Its a problem that plagues all sectors of Canadian society.

[bush_cheney2004]

Cuban system works quite well, just lacks technology. If we had the number of doctors per person that they do, there would be no problem. That is the real problem in most cases, lack of people. Its a problem that plagues all sectors of Canadian society.

Agreed....the Cuban doctors, nurses, and other medical professionals can't leave Cuba!

[Bryan]

If the NDP want to claim that they know how to "fix" healthcare, they need to stop implying that this is strictly a federal issue, unless they want to take it away from the provinces' jurisdiction entirely. I can't decide if that would be a bad thing or not. If we want to follow more along the lines of how some of the more successful programs in Europe work, it seems to me that it would have to be centralized. I just don't believe, being given central control over healthcare, that the federal NDP would do anything other than make it worse.

[Vancouver King]

If the NDP want to claim that they know how to "fix" healthcare, they need to stop implying that this is strictly a federal issue, unless they want to take it away from the provinces' jurisdiction entirely. I can't decide if that would be a bad thing or not. If we want to follow more along the lines of how some of the more successful programs in Europe work, it seems to me that it would have to be centralized. I just don't believe, being given central control over healthcare, that the federal NDP would do anything other than make it worse.

We need a return to federal transfers with strings attached. Provincial rights in the real world mean funds earmarked by Ottawa for health care more often end up in general revenue to be spent on other budgetary items.

Spend federal health transfers on health or lose the revenue.

[Riverwind]

Spend federal health transfers on health or lose the revenue.

Or eliminate the transfers and let the provinces raise the taxes to pay for healthcare. That would make the provinces directly accountable for the money spent and they would no longer be able to blame the feds for lack of funding.

[Riverwind]

Spend federal health transfers on health or lose the revenue.

Or eliminate the transfers and let the provinces raise the taxes to pay for healthcare. That would make the provinces directly accountable for the money spent and they would no longer be able to blame the feds for lack of funding.

[Vancouver King]

Or eliminate the transfers and let the provinces raise the taxes to pay for healthcare. That would make the provinces directly accountable for the money spent and they would no longer be able to blame the feds for lack of funding.

Unfortunately we could also wave goodbye to national health standards.

[Riverwind]

Unfortunately we could also wave goodbye to national health standards.

Why do we really care? We don't have national standards for education, social services or driver licensing/auto insurance. I would say those systems are in better shape because they are funded by the government that raises the taxes. Edited September 29, 2008 by Riverwind

[Bryan]

Or eliminate the transfers and let the provinces raise the taxes to pay for healthcare. That would make the provinces directly accountable for the money spent and they would no longer be able to blame the feds for lack of funding.

I think you are on to something here. Perhaps the whole structure of how revenue is accounted needs to be looked at. Certain taxes could go directly towards funding certain departments/programs, and not be available to general revenue. Then nobody has a leg to stand on with respect to blaming each other for lack of funding or wrong spending priorities.

[Argus]

Or eliminate the transfers and let the provinces raise the taxes to pay for healthcare. That would make the provinces directly accountable for the money spent and they would no longer be able to blame the feds for lack of funding.

Theoretically, one national system would eliminate a lot of waste and duplication, and be better able to negotiate cheaper prices with drug companies based on volume.

[cybercoma]

Or eliminate the transfers and let the provinces raise the taxes to pay for healthcare. That would make the provinces directly accountable for the money spent and they would no longer be able to blame the feds for lack of funding.

How does a province like New Brunswick with a population only around 750,000 people (not the working population even), with its vast remote areas and harsh climate provide the same medical service as a hospital in Toronto? The provincial taxes would need to be prohibitively high if you eliminated transfer payments entirely. You could argue that people should move away from remote areas, however that will just drive up the prices of property in the cities, which will make it impossible for even the middle class to live there. Transfer payments are in place so someone living in Fredericton, NB can receive the same quality of care as someone living in Toronto, ON; eliminating them would cause a bevy of issues that are unnecessary, not only in health care but other government services too.

I agree that provinces should be directly accountable for the money spent, but I also believe everyone in Canada is entitled to the same level of care. If that means transfer payments are necessary because provinces like Ontario can generate more revenue than they need, so be it. Perhaps an adjustment could be made to transfer payments that would allow the federal government to step back a little, while still ensuring that Canadians receive the same level of care no matter where they live or where they are traveling.

[cybercoma]

Theoretically, one national system would eliminate a lot of waste and duplication, and be better able to negotiate cheaper prices with drug companies based on volume.

This may not be a bad idea either, but I've always been leery about centralizing all of the power in Ottawa. Unfortunately, our country is a collection of regional interests and I think the government closer to the region would be better equipped to provide the services and standards, and to address the issues, for those regions.

What Jean Deau in Quebec wants is vastly different from John Doe in Alberta, which again is different from Jon Dough in Toronto.

[White Doors]

ok..

New Brunswick has a 'harsh' climate?

wha???

[Argus]

This may not be a bad idea either, but I've always been leery about centralizing all of the power in Ottawa. Unfortunately, our country is a collection of regional interests and I think the government closer to the region would be better equipped to provide the services and standards, and to address the issues, for those regions.

What Jean Deau in Quebec wants is vastly different from John Doe in Alberta, which again is different from Jon Dough in Toronto.

When they break their arm they want it set and put in a cast. I don't think desires for health care change depending on geography or culture. Maybe some of those foreigners in Toronto want clitorectomies, but that's about the only difference.

[PoliticalCitizen]

Agreed....the Cuban doctors, nurses, and other medical professionals can't leave Cuba!

Cuba, as the LEADER in North and South Americas' health care, sends its doctors for FREE to their Latin-American brothers...

Can you imagine: F R E E ?!

[bush_cheney2004]

Cuba, as the LEADER in North and South Americas' health care, sends its doctors for FREE to their Latin-American brothers...

Can you imagine: F R E E ?!

Cuba also sends boat people to Florida....F R E E !!

[Oleg Bach]

Cuba, as the LEADER in North and South Americas' health care, sends its doctors for FREE to their Latin-American brothers...

Can you imagine: F R E E ?!

No point in talking about real health care when you can not get a family doctor. No consistant quality care from a doctor that knows you meant no real quality health care - walk in clinics where unhappy practioners talk about skipping the country and joining Doctors With Out Boarders - as they with in five minutes attempt to perscribe and anti-depressant to you when it is they that are depressed. I heard a lady doc say to me - " I hate the government" If there is one hater there must be more. Medicine has become an industry where money is more important than health and care - so it's a lost persuit, attempting to revamp health care...we languished to long and lost site of the human factor - that we imported immigrants who's kids are now doctors - economic refugees...Medicine is a promise of wealth and status - gone are the days when you could pay the doctor with a chicken or by chopping wood.

[Riverwind]

Theoretically, one national system would eliminate a lot of waste and duplication, and be better able to negotiate cheaper prices with drug companies based on volume.

This country is too diverse and national programs tend to be used a way to buy votes in one region at the expense of others. This would completely undermine any 'economy of scale' offered by a national program. The provinces could easily collaborate when it comes to negotiating drug prices so that is not an argument in itself.

[Oleg Bach]

This country is too diverse and national programs tend to be used a way to buy votes in one region at the expense of others. This would completely undermine any 'economy of scale' offered by a national program. The provinces could easily collaborate when it comes to negotiating drug prices so that is not an argument in itself.

My nose is runny and I want to be hugged because no one love me - so off to emerge I go - I will get attention there..

[Argus]

This country is too diverse

Please tell me how you treat a broken leg in BC as opposed to Newfoundland. What's used to treat cancer in Alberta, and how is it different from what's used in Quebec?

and national programs tend to be used a way to buy votes in one region at the expense of others

.

Nonsense. If wait times were greater in BC than in Newfoundland, the government would have to explain that. If service was worse in PEI than in Ontario it'd be held responsible. There are basic measurement criteria for measuring health care deliverables which the government could not hide.

The provinces could easily collaborate when it comes to negotiating drug prices so that is not an argument in itself.

If they could easily collaborate why haven't they?

[John]

1) How much goes to health care transfers in the federal budget? Cut that amount and cut taxes with it.

2) The provinces should allow full competition for health care services. People should be free to either stay with government health care or use a private system. There's no reason why we can't have both.

Edited September 29, 2008 by John

[cybercoma]

When they break their arm they want it set and put in a cast. I don't think desires for health care change depending on geography or culture. Maybe some of those foreigners in Toronto want clitorectomies, but that's about the only difference.

How about where to put hospitals? Or deciding what services hospitals and clinics are going to provide? Or what amount of funding is going to go to which hospitals? I don't think Ottawa is close enough to the constituencies and facilities to make informed decisions on these matters. Sure, they can get all the information and wade through it, but the massive amount of labour needed to achieve that goal would cost quite a lot of money and the people making the decisions about areas won't necessarily be from there.

[cybercoma]

.

Edited September 30, 2008 by cybercoma

[Argus]

How about where to put hospitals?

Entirely based on demographics. I'm sure they can read statistics on Ottawa as well as at the provincial level.

Or deciding what services hospitals and clinics are going to provide?

Decided by the local health boards who don't care where their money comes from. Clinics are mostly private sector, though, and make their own decisions.

Or what amount of funding is going to go to which hospitals?

Again - it's a numbers game.

I don't think Ottawa is close enough to the constituencies and facilities to make informed decisions on these matters

.

It has nothing to do with being close to constituencies. These are all decisions based on numbers. And who says the bureacrats at Queens Park know any better about what people in North Bay or Kingston need than the bureacrats in Ottawa?