Freedom, Health Care, Glasnost & Perestroika

[August1991]

example: during the icestorm , generator prices were jacked up to gouge desperate buyers.

The benefit of having a generator is always the same. (ability to produce power)

Once again kuzadd, you've inadvertently touched on the key issue.

The benefit of a generator is not always the same - anymore than the use of operating room is always the same.

In the case of an ice storm, the benefit of a generator in a school might be greater than its benefit to power Christmas tree lights. The same principle applies to an operating room.

My point is that within our current health system, there is no way of knowing what the benefits and costs are. This inability to measure has dramatic consequences throughout the system and leads to many perverse results. In general, anyone who can play the bureaucratic game will benefit. It helps to have good contacts.

[kuzadd]

Once again kuzadd, you've inadvertently touched on the key issue.

The benefit of a generator is not always the same - anymore than the use of operating room is always the same.

In the case of an ice storm, the benefit of a generator in a school might be greater than its benefit to power Christmas tree lights. The same principle applies to an operating room.

My point is that within our current health system, there is no way of knowing what the benefits and costs are. This inability to measure has dramatic consequences throughout the system and leads to many perverse results. In general, anyone who can play the bureaucratic game will benefit. It helps to have good contacts.

You are talking about something else, the benefit of a generator is ALWAYS the same.

A generator makes power, that is all it does.

Your talking about the circumstances surrounding the benefit.

Within our current system there are tangible ways of knowing the costs, dollars spent for patients treated.

There is in fact lots of available information on the cost effectiveness of the system here vs other systems.

You never demonstrate the statements you make, I notice that, over and over.

All generalized "there is no way of knowing the benefits"

How about a lower infant mortality rate then in the US?

How about a longer life then in the US?

Are those not tangible and measurable benefits.

Of course they are!

They simply aren't the facts that an idealogue wants to consider.

And that is what you and your article boil down to, ideology..

You and someone else think or have the opinion that your correct.

And you use spin, to promote that idea.

Hence the title and tone of the article.

No substance.

[madmax]

August 1991:

In the matter of healthcare, cost can never exceed benefit. Its an effing GoldMine!

Private companies are excellent at extracting the gold and leaving the shaft. The best way is to get the public to pay and jack up the bill. Cut costs, provide service to fewer people, add in costs per visits and other user fees, and get another tit to suck on.

It is a Gold Mine, and there is so much money, that Private Insurance companies drool to get a piece of the action.

Of course some people think it is about Health Care.

Just came back from Georgia last month. My friends run a small business with a staff of 50. They used to have a business in Ontario, but they like to golf all year round.

I was shocked to hear that there taxes etc, were very close to Ontarios. I thought they were full of it. BUt they showed all the other kinds of taxes they have to pay that we don't, and then, that was before what they pay in health care costs. Then they still need private insurance for their employees and pretty much, if you are sick, have developed Cancer, or a bone disease or MS, you lose your coverage, your hospital and your doctor.

Good eh.

[Michael Hardner]

TB,

Post #95

I see no evidence that business is any more accountable. At least with politicians you can fire them by voting them out of office.

Business is inherently accountable to its stakeholders - including owners and customers.

And how precisely would your system differ than the US's? In what fundamental way?

Because it's single-payer. The government would still hold an absolute domain over rates, and there would be no free market.

And if they don't?

Then the project has failed and something else needs to be tried.

If it is taxpayer funded, then at the end of the day, it must be accountable in some way.

True, but it's not accountable now. The healthcare system is barely monitored as it stands today. If a public/private partnership is more closely watched, then all healthcare institutions need the same level of monitoring.

And please, don't wave the "business is accountable through profits" nonsense. The latest fiascos have demonstrated just how unaccountable business can be, unless you call bankruptcies and buyouts a form of "accountability". So how would it be accountable if not ultimately to the electorate?

To say that because the financial sector in the US took on excessive risk and collapsed means that the profit motive is invalid - well that's just not true.

If you have a better way to restructure the system then suggest it.

After all, it would still be taxpayer money. I suppose you can pay ten bucks an hour for cleaning staff, but then you get ten bucks an hour worth out of it (I've seen personally these staff in action, hospitals in BC are nothing like they were ten years ago).

You can't tell me how much the cleaning staff cost is impacting healthcare because it's not reported. This is the problem - lack of accountability.

Virtually every health care system in the industrialized world is in one stage of crisis or another. The problem ultimately isn't politics, it isn't whether it's run by evil socialists or evil corporate entities, it's because in most industrialized countries, the demographic is getting older, the system is becoming burdened by insufficient numbers of young healthy taxpayers coming into the system to pay for the baby boomers who are now beginning to strain the system. All the user fees, all the contracting out (which is, let's face it, what you're really saying) won't fix the root issue. The only thing that will is more babies, and that will only begin to fix it in twenty to twenty five years, even if we saw birth rates skyrocket right now.

Again, if that's the case then why are the basic requirements of running a system not being met ? We hear the idea of demographics and of 'studies' but these things are known factors, and therefore should be planned for.

JFortin,

Your idea sounds valid on the surface, but I'd be curious as to how much internal bureaucracy a private hospital faces versus a public hospital.

*

And, TB and JF, please understand that I didn't support private healthcare solutions even five years ago. I'm just tired of politicians like McGuinty and Paul Martin saying things like "we will fix healthcare for a generation" and having nothing change. My experience tells me when a problem becomes so complex, and so entrenched, it's sometimes better to start over than to try to fix the current system.

[White Doors]

Well, not all provinces have the raw fossil fuel supplies that Alberta does. I wasn't aware that there were people that actually thought that Alberta somehow pulled itself out of its duldrums, rather than simply being rather like that the price of a barrel of oil provided the economic "miracle".

And besides, isn't the oil patch now coming hat in hand looking for bailouts from the Federal Government? When the price of oil is astronomically high, suddenly it's because Ralph Klein was some sort of economic genius, but when the price of oil drops below the threshold necessary to sustain Alberta's oil industry, it's all about Alberta getting its fair shake.

I'd like to believe that it's only the Conservatives and their supporters that are hypocrites, and not the entire province.

Alberta got rid of it's net debt largely when Oil was trading at $20/barrell. Also, from your rhetoric, I am assuming that you are from BC? You are hardly in a position to delegitimize Alberta's success by inferring it's just cause of their natural resources! lol If it was just about Natural resources, BC should have had it's debt paid off in the 60's!

[kuzadd]

Michael hardner: Business is inherently accountable to its stakeholders - including owners and customers.

Yes, we can see the accountability business demonstrates....

Enron, Worldcom, Goldman-Sachs, AGI, all so accountable for their mismanagement.

Fraud, fraud, fraud, is that accountability?

Taxpayer handouts is that accountability?

Bundling bad mortgages and selling them as safe investments, yah, that is accountability?

Business being accountable is simply more ideology, unsubstantiated ideology.

It's like religious belief , swallowed up unconditionally. Allelujiah

propogated of course by the business class, for their own benefit, to be swallowed up by rubes without question.

Edited December 17, 2008 by kuzadd

[OddSox]

1. If privatization 'for-profit' is so offensive that it has to be stamped out at all costs - why are dentists, optometrists, pharmacies, etc. allowed to operate the way they are?

2. If a walk-in clinic or an x-ray clinic can operate efficiently enough to make a profit, then why can't we have hip-replacement clinics, private emergency rooms, MRI clinics, palliative care units and even smaller more-efficient hospitals - all operating under the same fee-for-service system that is currently in place?

On the side note in this thread, the gun-registry is not accessed 'thousands of times per day' - CPIC is. (http://www.cpic-cipc.ca/)

[Jerry J. Fortin]

I suspect that someone from PEI would take slight to your post as you seem to have taken slight at mine.

I meant no harm. (As it is, both my parents came from tiny communities, one from Newfoundland - current population 700,000 or so.)

Such places are nothing like Moscow or Paris.

Fortin, the additional expense is not administrative charges. The expense (cost) is due to confusion.

No one knows what is going on. Well meaning hospital administrators use spread sheets and computer programs to figure out how to organize ER and surgical staffing. Meanwhile, hospital staff meet in committees or chat during a cigarette break and gossip about rumoured changes. No one really knows what the effect of anything is - but any change with the potential to affect a person's livelihood meets with immediate scrutiny.

This is how the Soviet Union operated and how most bureaucracies operate. The only question is how far they can divorce themselves from reality and for how long. The managers at GM have a short leash. The managers in the Ontario health ministry have a long leash.

I do not mean to imply that administrative expenses are the only factor, but they in fact are a factor. To this I will add that GM is not exactly a good model to point at and claim economy and efficiency of private ventures when the company is in the process of going belly up. Short leash? How many billions were paid in bonus and salaries? These inflated the unit cost per vehicle which has in conjunction with the high cost of labour adversely impacted competitiveness in the industry.

The confusion you speak of is founded in the speculation involved in funding, that is a true statement yet it does not address the real issues of the additional expense of a profit. That profit must be paid for, but by whom? Look at the cost of healthcare to the citizen in Europe. Yes the facts state that it is either X or Y but the reality is that the citizens AND their employers are spending money hand over fist in addition to the money that governments kick into the pile by way of direct and indirect taxation.

Heathcare funding is the third rail in Canadian politics, mess with the system and face political uncertainty at least. Taken in small measures as in the case of Alberta or Quebec provincial efforts is one thing and taken in large measures by the federal government is another altogether.

[Canadian Blue]

Well, not all provinces have the raw fossil fuel supplies that Alberta does. I wasn't aware that there were people that actually thought that Alberta somehow pulled itself out of its duldrums, rather than simply being rather like that the price of a barrel of oil provided the economic "miracle".

And besides, isn't the oil patch now coming hat in hand looking for bailouts from the Federal Government? When the price of oil is astronomically high, suddenly it's because Ralph Klein was some sort of economic genius, but when the price of oil drops below the threshold necessary to sustain Alberta's oil industry, it's all about Alberta getting its fair shake.

I'd like to believe that it's only the Conservatives and their supporters that are hypocrites, and not the entire province.

We did, take note of the massive cuts that took place in the early 90's and the fact we became the second freest economy in North America due to this crazy idea Albertan's have that private enterprise is a good thing. Something that apparently even Gordon Campbell in British Columbia realized when he cut taxes by 25%.

By the way I'm not fan of the PC's, I think they've done a horrible job in the last 4 years when it comes to fiscal restraint and I'm not afraid to say so. I didn't vote for them in the last election precisely because of that fact. Our province is now facing a deficit because of the new royalty framework, not to mention the fact they've been spending money like a drunken sailor in a whorehouse.

Enron, Worldcom, Goldman-Sachs, AGI, all so accountable for their mismanagement.

Yes they are. At the very least those companies can go bankrupt and investors can simply stop funding them, the same can't be said for government.

Taxpayer handouts is that accountability?

No, that's corporate welfare. Something most principled conservatives would be against.

With regards to healthcare, just once, just once I'd like to see someone whose against allowing private healthcare not point to the United States. If you're entire argument is that we shouldn't be "American" and that's it you should try re-evaluating your position so it's not based on an infantile knee jerk reaction. The United States healthcare system is just a mess of bureaucracy, massive regulation, and largely ineffective government welfare programs.

What most people on here who are supportive of allowing private healthcare are arguing is that we should look at what the Netherlands, Switzlerand, and Singapore, do. They allow a large degree of private enterprise and competition yet it doesn't seem like people are out dying on the streets.

That being said, what exactly is wrong with attempting a new way of doing things. I find this especially ironic coming from people who describe themselves as liberals, you'd think they'd be the last ones to be opposed to making any changes.

Edited December 17, 2008 by Canadian Blue

[Canadian Blue]

Think about it people, theirs a problem with the system when farm animals and pets get faster treatment than humans.

[Smallc]

Think about it people, theirs a problem with the system when farm animals and pets get faster treatment than humans.

So what do you think would happen if suddenly all pets were able to get the care they needed? Do you think that the service would be so quick then?

[madmax]

Think about it people, theirs a problem with the system when farm animals and pets get faster treatment than humans.

Sure, and some people pay for funeral services for their animals and spend $10,000 for a coffin. Other people stop paying for flufflies fixes and pay for the final needle, because it is cheaper.

Well Grandma, a Hip replacement is $15,000 we don't have, but this needle is only $200 and we have coverage for the burial.

As for faster treatment.

It was in the private clinic in Quebec that a patient recently died while waiting for faster treatment. He had been dead so long in the clinic, that CPR wasn't attempted and rigamortis had set in.

Many private clinics are happy to give fast treatment for some Gauze and a bandage and send you off with a $1500 bill. And a $90 registration fee

[Canadian Blue]

So what do you think would happen if suddenly all pets were able to get the care they needed? Do you think that the service would be so quick then?

Depends on the system.

Well Grandma, a Hip replacement is $15,000 we don't have, but this needle is only $200 and we have coverage for the burial.

As for faster treatment.

It was in the private clinic in Quebec that a patient recently died while waiting for faster treatment. He had been dead so long in the clinic, that CPR wasn't attempted and rigamortis had set in.

Many private clinics are happy to give fast treatment for some Gauze and a bandage and send you off with a $1500 bill. And a $90 registration fee

Awe yes, the good ole appeal to the heartstrings to tell us all why we should love being mediocre together. It'd odd that their still hasn't been a single rebuttal to the idea that competition would be a good thing in the healthcare system, or for that matter why provinces shouldn't experiment with different methods of healthcare delivery to see what works best for the citizens of this country.

I personally still find it somewhat odd that individuals have blind trust of everything the government does, and will never consider allowing private healthcare to operate in Canada. Despite the fact that the majority of countries with universal healthcare often allow private for profit healthcare.

But I suggest that you go off an make some half baked Hallmark movie about how Grandma won't get a new hip due to evil capitalists.

Edited December 17, 2008 by Canadian Blue

[Smallc]

Depends on the system.

With this system. You seem to like it. What do you think would happen in the US if suddenly everyone had access to the entire system? Yeah, they have more of some equipment than us, but according to the most recent numbers, they have only slightly more in the way of doctors and they actually have a more serious nursing shortage. Private enterprise may help, but on the other hand, it may not change anything. Thorough study is needed.

[ToadBrother]

Yes they are. At the very least those companies can go bankrupt and investors can simply stop funding them, the same can't be said for government.

Those companies didn't just go bankrupt, they stole billions from investors. Please don't minimize it. Those companies were far worse than even the Liberal's sponsorship scandal.

So unless you're going to provide some means that these companies can be guaranteed not to screw around the taxpayer, I say stick with government. As inept and inefficient as it is, at least we have a means of getting rid of the guys at the top.

That being said, what exactly is wrong with attempting a new way of doing things. I find this especially ironic coming from people who describe themselves as liberals, you'd think they'd be the last ones to be opposed to making any changes.

What you seem to be advocating is a change back to the way it was prior to Medicare. How is that a change for the better? There's a reason Canadians demanded it. Care to guess why?

[White Doors]

With this system. You seem to like it. What do you think would happen in the US if suddenly everyone had access to the entire system? Yeah, they have more of some equipment than us, but according to the most recent numbers, they have only slightly more in the way of doctors and they actually have a more serious nursing shortage. Private enterprise may help, but on the other hand, it may not change anything. Thorough study is needed.

Every American and even illegal immigrant has access to the American healthcare system.

You should probably do some research.

[White Doors]

So unless you're going to provide some means that these companies can be guaranteed not to screw around the taxpayer, I say stick with government. As inept and inefficient as it is, at least we have a means of getting rid of the guys at the top.

Uhh... the guys from Enron et al are in Jail.. lol

[Smallc]

Every American and even illegal immigrant has access to the American healthcare system.

Doesn't mean that they all have the ability to use it. Sometimes people can't pay and aren't covered by anything else. Sometimes, people are simply afraid to go to the doctor because they don't want the bill.

Edited December 17, 2008 by Smallc

[kuzadd]

and for all the blathering Canadian blue did.

There was no mention of how it is a fact that business is more accountable then government?

The US system is largely private, the Canadian sytem largely public, if you are arguing for privatisation, there is no guarantee, what with NAFTA and other movements towards...shall we say, unity with the US, that you will get any other particular system.

So rather then knee jerk, it is just really facing up to the reality of the said situation.

How much taxpayer dollars are the bail-outs of the private banks and business ?

[Canadian Blue]

With this system. You seem to like it. What do you think would happen in the US if suddenly everyone had access to the entire system? Yeah, they have more of some equipment than us, but according to the most recent numbers, they have only slightly more in the way of doctors and they actually have a more serious nursing shortage. Private enterprise may help, but on the other hand, it may not change anything. Thorough study is needed.

Just once when discussing healthcare in Canada I wish people wouldn't revert to their knee jerk anti-American tendencies. If you actually bothered to read what I wrote, which you haven't, you'll notice that the system I support would work in conjuction within the framework of universal healthcare. The difference is that the funding would follow the patient, and health insurance companies would instead have to compete for that money.

If all people in the US who don't have insurance were aware of the kinds of welfare programs in place, the US would likely have coverage levels close to 99%. But I've stated many times before, I don't support a system anything like that of the United States, the only problem is that when liberals such as yourself hear anything positive said about business, competition, or private enterprise, the immediate kneejerk reaction is to talk about how that's "American" or give some half-baked tug at the heart strings.

You still haven't stated why allowing provinces to allow changes in their healthcare delivery will be a bad thing, or for that matter why allowing even an element of competition in the system will denigrate universality. So far the only charge I've heard is that we can't do it because it sounds "American." Unfortunately I don't share such a repulsion whenever I hear the word "American."

[White Doors]

Doesn't mean that they all have the ability to use it.

Yes, yes it does in fact. American hospitals have to treat anyone that has a need for medical attention regardless of their ability to pay.

[Smallc]

Just once when discussing healthcare in Canada I wish people wouldn't revert to their knee jerk anti-American tendencies. If you actually bothered to read what I wrote, which you haven't, you'll notice that the system I support would work in conjuction within the framework of universal healthcare.

So why were you holding up veterinary medicine as an example then? It seems to have a great deal in common with the US system.

[White Doors]

and for all the blathering Canadian blue did.

There was no mention of how it is a fact that business is more accountable then government?

The US system is largely private, the Canadian sytem largely public, if you are arguing for privatisation, there is no guarantee, what with NAFTA and other movements towards...shall we say, unity with the US, that you will get any other particular system.

So rather then knee jerk, it is just really facing up to the reality of the said situation.

How much taxpayer dollars are the bail-outs of the private banks and business ?

If you want to be the most popular person in your class, whenever the professor pauses in his lecture, just let out a big snort and say "How do you figger that!" real loud. Then lean back and sort of smirk.

[Smallc]

Yes, yes it does in fact. American hospitals have to treat anyone that has a need for medical attention regardless of their ability to pay.

Who determines if you have a "need." Everyone has access in an emergency, yes, but for preventative medicine? For routine checkups and physicals?

[White Doors]

So why were you holding up veterinary medicine as an example then? It seems to have a great deal in common with the US system.

And the various European systems too, especially when you compare wait times and health outcomes.

Yes, fido get's better access to healthcare than do fido's parents in this country and that's just the way we like it apparently, 'cause it's not like them thar yanks, hyuk.