Freedom, Health Care, Glasnost & Perestroika

[August1991]

Dans sa première sortie publique depuis son départ du ministère de la Santé, Philippe Couillard a livré, devant une assemblée d'assureurs, un véritable plaidoyer pour le privé en santé. Pour se réinventer, le réseau de la santé doit, selon lui, autoriser l'ouverture de plus de cliniques privées associées, permettre aux médecins québécois de pratiquer dans le privé et autoriser les Québécois à contracter des assurances privées pour des actes couverts par le régime public.

Cybrepresse

Our provincial health systems fail because people are not free to choose: neither interns, doctors, nor patients. All are subject to bureaucrats and ministry directives. Our health system is Soviet.

Couillard has seen this system from inside and from the top. I tend to agree that at this point, only private system can solve the problems this Soviet regime has created.

----

IMHO, Quebec is ahead of many English Canadians on such issues. The question is not ideological - the question is, what works?

[Smallc]

Our provincial health systems fail because people are not free to choose: neither interns, doctors, nor patients.

That's certainly not the way it works in my province. Decisions are made by the doctor and the patient. Procedures then take place at the private not for profit clinics and hospitals. They aren't always covered, but are in the vast majority of cases. I would guess that it is the same in most provinces. I know its the case in AB, SK, ON, and BC along with my own MB.

Edited December 16, 2008 by Smallc

[punked]

You give me an example of a health care system that works and I will say yah lets switch. Until then I am unmoved.

[Smallc]

You give me an example of a health care system that works and I will say yah lets switch. Until then I am unmoved.

Not only that, we have to be able to ensure that it would work here. As long as a system that was better would work here and would allow everyone timely access, I would be completely open to it.

[punked]

Not only that, we have to be able to ensure that it would work here. As long as a system that was better would work here and would allow everyone timely access, I would be completely open to it.

Agreed, those are all important things. Changing to something real and tangible is the idea of the game not changing for the sack of changing when the system could get a lot worse.

[Smallc]

Quebec is ahead of many English Canadians

Oh, and this gets very tiring. We're all Canadians. There's no reason to point out differences that seem rather arbitrary and stereotypical.

[August1991]

That's certainly not the way it works in my province. Decisions are made by the doctor and the patient. Procedures then take place at the private not for profit clinics and hospitals. They aren't always covered, but are in the vast majority of cases. I would guess that it is the same in most provinces. I know its the case in AB, SK, ON, and BC along with my own MB.

You live in Manitoba?

That's like living in Rimouski.

Oh, and this gets very tiring. We're all Canadians. There's no reason to point out differences that seem rather arbitrary and stereotypical.

No. I am attempting to explain teh situation of French in North America.

You English North Americans are naive.

Edited December 16, 2008 by August1991

[blueblood]

You live in Manitoba?

That's like living in Rimouski.

No. I am attempting to explain teh situation of French in North America.

You English North Americans are naive.

And Quebecers are like High maintenance women. Calling a quebecer a seperatist is like calling a woman fat. We're supposed to automatically understand you guys, but you won't tell us your problems. Quebecers place high demands, high maintenance women place demands. It's all right for Quebecers to do something, but it's not alright for the ROC (reasonable accomodation, language laws), it's all right for high maintenance women to call other women fat, but hell awaits the guy that does so.

As a person from Quebec speaking to English Canadians, you go on and on about how we don't get Quebec, and how Harper doesn't get Quebec, honestly how are we supposed to "get" Quebec, if we haven't a clue what we're in for. If this is how Quebecer's act, (pout about how English Canada doesn't get them, yet won't tell us what we're supposed to get) can you understand why Quebec is so frustrating for the Rest of Canada?

[Smallc]

You live in Manitoba?

That's like living in Rimouski.

I'm really not seeing the parallel.

[Bryan]

That's certainly not the way it works in my province. Decisions are made by the doctor and the patient. Procedures then take place at the private not for profit clinics and hospitals. They aren't always covered, but are in the vast majority of cases. I would guess that it is the same in most provinces. I know its the case in AB, SK, ON, and BC along with my own MB.

Less than it used to be though. The govt has been crushing private care in favor of less and less efficient "soviet" care for several years now. Both the WRHA and the public purchase and conversion of Pan Am Clinic are shining examples what not to do with health care. In both cases, a lot of money has been spent, a lot of choices have been taken away, and service has deteriorated dramatically. Pan Am used to be the gold standard of how health care should be done: a fully private clinic offering services within the public system as well as value added private services. They were fast, efficient, and service was excellent. Now they are just another inefficient public hospital.

[Smallc]

Now they are just another inefficient public hospital.

Its not a public hospital. As far as I know, there is no such thing in Manitoba. I don't see where the complaint comes from in terms of Manitoba's system. I've had (and my family has had) first hand experience with the system and every time we have received timely care with choice at every turn. I have no complaints.

[blueblood]

Its not a public hospital. As far as I know, there is no such thing in Manitoba. I don't see where the complaint comes from in terms of Manitoba's system. I've had (and my family has had) first hand experience with the system and every time we have received timely care with choice at every turn. I have no complaints.

No public Hospitals? Where in the blue hell do they get their funding from? The only time I've gotten timely care at a hospital is when I came in an ambulance.

[Smallc]

No public Hospitals? Where in the blue hell do they get their funding from? The only time I've gotten timely care at a hospital is when I came in an ambulance.

Well, you live in Dauphin, and I will admit that there are problems there and in some other rural hospitals, but that is a function of staffing shortage...a problem that exists across North America. Steps are being taken to address it.

As for the hospitals themselves, they do get a lot of public funding, but they are in fact charitable foundations.

[jdobbin]

The question is not ideological - the question is, what works?

It isn't ideological? You want no public healthcare, it seems.

What system do you want? Totally private? No public funds? Do you think this will be cheaper? Do you think some people will just opt out and take their chances?

[Bryan]

Its not a public hospital. As far as I know, there is no such thing in Manitoba. I don't see where the complaint comes from in terms of Manitoba's system. I've had (and my family has had) first hand experience with the system and every time we have received timely care with choice at every turn. I have no complaints.

The provincial govt bought Pan Am outright, and the WRHA took control of the Winnipeg hospitals several years ago. They are all public now.

I too have had great service until recently. In the last couple of years things have deteriorated very badly.

[Shakeyhands]

The only time I've gotten timely care at a hospital is when I came in an ambulance.

This is a pretty funny comment. Did you expect to go ahead of the people who were really hurt/sick when you stumbled in the other times?

This is the "problem" with our system, those that think that their itchy parts or other non life threatening ailments be treated ahead of the guy with the swelling brain from the car accident because he was there first.

[White Doors]

It isn't ideological? You want no public healthcare, it seems.

What system do you want? Totally private? No public funds? Do you think this will be cheaper? Do you think some people will just opt out and take their chances?

I don't think emulating practices that seem to work well in Switzerland and France and trying to incorporate them here has to be an ideaological issue.

Personally, I think good health care is more important than Ideaology, I know that you never would.

[Jerry J. Fortin]

There is room for much improvement within our system, of that there is no doubt. Yet privatization has a profit motive, which indicates an additional expense to all involved. That solution is one in which the individual is reduced to a paying customer instead of a citizen in need of help. Surely there is a way to improve our own system.

[White Doors]

There is room for much improvement within our system, of that there is no doubt. Yet privatization has a profit motive, which indicates an additional expense to all involved. That solution is one in which the individual is reduced to a paying customer instead of a citizen in need of help. Surely there is a way to improve our own system.

Of course privatization has a profit motive. Profit is not a bad word however. It also does not mean additional expenses for everyone. Does it come as a shock to you that private businesses may be able to operate more efficiently than large government bodies? seriously?

There are lots of places for a business to deliver quality, timely care that would far exceed the public health systems ability to do so and in turn, cost less as well (including say a 10% or 15%) profit.

We are already a paying customer in our current system - Family practices are businesses and they are paid per visit. You are dollar signs in the eyes of your family Dr now and have been for 40 years. How do you feel about that? Make you feel dirty?

IF only as a country we could get away from this juvenile partisan language war we would be able to move on and actually improve our system. Quebec has been leading the way actually. Thanks to their Supreme court decision, they are and will be leading the way on privatisation efforts there. Ever wonder why the NDP doesn't campaign hard against that?

[kuzadd]

'White Doors'

Of course privatization has a profit motive. Profit is not a bad word however.

this is just more baloney.

Profit is not a bad word. Wether it is a "bad" or "good' word is irrelevant, words don't have values.

Profit- how much, on who's back, how many can afford to pay???

It also does not mean additional expenses for everyone

.

Yes, profit does mean addtional expenses, it most certainly does and anyones who believes or claims otherwise is a blithering idiot. Case in point. The US system, look at the cost of it for the services rendered. Operation cost per operation cost, profit increases the expense.

Does it come as a shock to you that private businesses may be able to operate more efficiently than large government bodies?

A belief, an ideology. But does it? Really? Is business able to operate more efficiently?

Well look around buddy boy... All the "efficient" businesses going down the tubes, banks, car manufacturers, and more.. Must be all that efficiency? Taking peoples livelihoods on down with them. One would think had these business been run efficiently they would wether the storm, but infact, they have been run foolishly, corruptly.

But cars aren't healthcare.

Healtcare is a human right, a car is not.

There are lots of places for a business to deliver quality, timely care that would far exceed the public health systems ability to do so and in turn, cost less as well (including say a 10% or 15%) profit.

pure speculation. And you couldn't substantiate this if you tried.

It seems the supporters of for profit medicine, are the biggest promoters of a nonsensical ideology.

Business can do things more efficiently, and cost effectivley.

Pure ideological fantasy, and years of corporate brainwashing done to serve... drum roll please.. CORPORATIONS.

Edited December 16, 2008 by kuzadd

[Jerry J. Fortin]

I agree , the question is not whether or not profit is a good or bad word. It is not about the ineffectiveness of government or the efficiency of private enterprise. It is about the net cost to the consumer, and including a profit margin will in fact raise that cost.

[White Doors]

I agree , the question is not whether or not profit is a good or bad word. It is not about the ineffectiveness of government or the efficiency of private enterprise. It is about the net cost to the consumer, and including a profit margin will in fact raise that cost.

Not necessarily.

One only need to look at the relative costs of systems that have two tier health care to see that you are indeed incorrect in this assumption.

[Smallc]

The provincial govt bought Pan Am outright, and the WRHA took control of the Winnipeg hospitals several years ago. They are all public now.

I too have had great service until recently. In the last couple of years things have deteriorated very badly.

The WRHA is a semi private organization. The hospitals that they run are turned into private not for profit charities. From what I have heard, there is no such thins a public hospital in Canada in the same sense as there is in England.

I still receive good service the majority of the time. New equipment is being bought all of the time and new facilities are being opened all of the time. The big problem now is a staffing shortage, and that's not only a Manitoba or Canada problem.

[White Doors]

Yes, profit does mean addtional expenses, it most certainly does and anyones who believes or claims otherwise is a blithering idiot. Case in point. The US system, look at the cost of it for the services rendered. Operation cost per operation cost, profit increases the expense.

Look at other systems that have a profit motive and they in turn spend less of their GDP on healthcare and have better outcomes. Ergo, your inference is incorrect and you are the idiot.

Walmart makes tonnes of profit yet they have the best prices around. You would need to understand economics 101 to get this however.

A belief, an ideology. But does it? Really? Is business able to operate more efficiently?

Well look around buddy boy... All the "efficient" businesses going down the tubes, banks, car manufacturers, and more.. Must be all that efficiency? Taking peoples livelihoods on down with them. One would think had these business been run efficiently they would wether the storm, but infact, they have been run foolishly, corruptly.

But cars aren't healthcare.

Healtcare is a human right, a car is not.

Au contraire, the businesses that are doing badly right now are the one's that were not runnng efficiently.

One only need to contrast Toyota with that of the big 3 to see that clearly.

(This coming from a GM car owner)

Not sure that healthcare itlsef is a human right, but the Quebec supreme court ruled that timely access to healthcare cannot be over ridden by ideaology. Take your juvenile argument to them and see how you do.

[Michael Hardner]

The main problem with this problem is that we have no way to frame it for the public.

The healthcare discussion is very complex, and it happens only in terms of 'reports' and 'press releases' by interested parties, including the health ministries themselves. We don't have access to the data, so we can only parrot information that comes from those interested parties.

But, the good news is that Canadians have begun to get so frustrated that they're actually demanding results. For example, it actually looks like *both* sides of the debate here on MLW are concerned with costs. That means we have a consensus ! (Step 1)

Now, we would only need an organization to start a pilot project to achieve a goal. If we had an independent and trustworthy organization that could monitor the pilot project, and provide reliable performance reports, and some organizations to try it - then we would we would have a proposed solution ! (Step 2) There is currently one body that provides national healthcare statistics, the Canadian Institute for Health Information. Their reports are useful, but they don't report on everything.

My feeling is that August1991 and the pro-private health care are right, and that the time has come for us to engage the private sector. However, this action will be useless unless Canadians are better equipped to determine whether these projects are successful or not.

I think that it would be amazing if someone initiate a citizen's interest group that partnered with CIHI, a private provider, and a provincial health ministry to propose such a pilot project. (And now... the fantasy part.... ) A web such as MLW would be a fertile ground for supplying a good cross section of interested citizens for the project.