Freedom, Health Care, Glasnost & Perestroika

[Smallc]

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

Canadians have very good health outcomes. I haven't seen statistics that paint the picture in health outcomes as being much worse than in any other country and sometimes, they are better. They are there to find if you want to look. Canadians live long lives, and part of that I woulds say, is because of our access to care. I have never experienced a real problem with the system. Sometimes, I don't like the wait for elective procedures, but most of the time, I haven't even had a complaint.

Yeah, I want improvements, but I want meaningful improvements that don't change the universal access of our system.

Edited December 17, 2008 by Smallc

[kuzadd]

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.

indeed it does, just look at the number of "unfixed" cats.

Seems people love a kitten, but heck, it's so cute and fuzzy and sweet.

BUT, no stopping them dumping the kittens in the country , or taking them to the humane society.

When they become to much of a nuisance.

Just pay to fix them, but the cost, the cost....

And how many people opt to put their pets down, when they require expensive treatments, because they cannot afford treatment?

Hmm, perhaps with privitization, we will see a swing upward in Euthansia.

Can't afford the treatment......

That should get the christian right up in arms, playing god and all..........

Edited December 17, 2008 by kuzadd

[ToadBrother]

TB,

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

No it's not. That's a lovely fiction, but the financial scandals show A. businesses and rating agencies can get into bed together to deceive investors and customers, B. price collusion, C. fundamentally, there's little accountability to individual investors, unless they are large investors.

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

So what you're suggesting is the American model. For the poor folks there will be some sort up-front credit. Is that it?

Will the system still be available to all Canadians? Will hospitals be forbidden from turning away people because they can't pay, or not doing procedures for that reason? Right now, the electorate has a direct voice by the ability to throw out a government if it screws up, how would we retain that power in your system? Would contracts be limited to the term of the Provincial governments, with contracts renegotiated after each election?

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

It's hardly failed. My wife still got her cancer treatments. Her life was saved, and we didn't go bankrupt in the process. What else can I ask from a health system?

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.

Surely we can monitor without private contractors, no?

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.

I didn't say the profit motive was invalid, I'm saying that business can be no better and in some cases much worse. If a health contractor goes bankrupt, where do we sit then? The government would essentially still have to underwrite, so in effect, we have a worthless middle man skimming profits, likely by cutting corners, paying inadequate wages to support staff, trying to move more and more essential services to the non-essential side.

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

Start slashing the management massively, start centralizing health service, and not just the way it was done here in BC, where yet again, one level of bureaucracy was simply replaced by another even less accountable level of bureaucracy.

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.

I don't see how making the electorate even less capable of making its will known is an improving of accountability.

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.

How do you plan for a major drop off in front-end revenues? The only ways I know are either to increase taxes or to decrease services. I suspect efficiencies will only get you part of the way, and not very far at that. I doubt the system is so inefficient that we can simply reorganize ourselves back into shape.

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.

Where in this does the public will come in? Canadians have made it clear, they want Medicare. All the rhetoric from the conservative think-tanks in the world won't change the facts.

What I think we should do is simply start by telling the truth, that to maintain and upgrade our system, we're all going to ahve to pay more money. We can either do it on a user basis (user fees) or we can collectively throw our taxes into it. I hate taxes as much as the next guy, but I'd rather see my taxes go up than to have to fear getting sick and having some unaccountable contracted firm say "No, I'm sorry, you're credit card bounced, we won't admit you for surgery."

Edited December 17, 2008 by ToadBrother

[White Doors]

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

No, of course not. Which is why I, and others here who are advocating for increased private involvement are not using the USA as an example. It's to the other extreme.

ie: Are you able to envision two-tier healthcare in Canada in your minds' eye without the video of W ducking that size 10 shoe?

[Michael Hardner]

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?

To point out the financial system failure as a reason for not persuing private involvement in the healthcare system is a stretch. It's like someone saying that the public system is Marxist and look what Lenin did.

In fact, we need to be pragmatic and look at new ways to manage the system. This is the most obvious.

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.

This post has been edited by kuzadd: Today, 08:14 AM

If you don't like the private-public partnership idea, then suggest another. A purely public solution, though, would have to be different in order to not fall into the pitfalls we already have.

[Canadian Blue]

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.

Perhaps we should nationalize all industry in the interests of ensuring the taxpayers don't get screwed. This is ridiculous reasoning, as it basically argues that people should simply give a monopoly to government over everything because one company screwed up.

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.

Not really, Canada can still implement our own laws and if you can please inform us how Canada will get the exact same system as the US I'd like to hear it.

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

Because if business is incompetent, corrupt, or generally lazy, it'll either go bankrupt or in the case of Enron executives go to jail. With government we all get screwed over equally and the politicians keep their pay cheques and pensions.

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.

Only because you have no clue what the American system actually entails. As I said before you should try thinking more in terms of reason instead of waking up everyday telling yourself that you're not an American.

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

I'd rather be able to spend $50 dollars of my own money to get a routine checkup in an expedient manner rather than wait months on end because you dislike the idea of allowing doctors the freedom to work in a private practice if they wish.

But atleast we're not like those damn American's.

[ToadBrother]

Canadians have very good health outcomes. I haven't seen statistics that paint the picture in health outcomes as being much worse than in any other country and sometimes, they are better. They are there to find if you want to look. Canadians live long lives, and part of that I woulds say, is because of our access to care. I have never experienced a real problem with the system. Sometimes, I don't like the wait for elective procedures, but most of the time, I haven't even had a complaint.

Yeah, I want improvements, but I want meaningful improvements that don't change the universal access of our system.

Let's face it, the objections to Medicare are ideological. The system has its problems, but then again, every single health care system in the Industrialized world is having problems due to aging populations. Among the more Libertarian Conservatives, there has always been a hatred of Medicare, and now they're latching on to every single problem and claiming the system is collapsing. That's just utterly bogus. If private systems or private-public systems worked, then the US and Great Britain would be paragons of health care virtue, but in fact, their systems have all sorts of systemic problems.

The Libertarians in the conservative movement want to deceive Canadians into throwing the baby out with the bathwater. That's what "starting over" really means, it means destroying Medicare and restoring the old system. I'm sure they'll go along with throwing tax credits and such at lower income Canadians, but let's remember, Medicare is universal, health care "gift cards" can be rescinded at any time.

[White Doors]

Canadians have very good health outcomes. I haven't seen statistics that paint the picture in health outcomes as being much worse than in any other country and sometimes, they are better. They are there to find if you want to look. Canadians live long lives, and part of that I woulds say, is because of our access to care. I have never experienced a real problem with the system. Sometimes, I don't like the wait for elective procedures, but most of the time, I haven't even had a complaint.

Yeah, I want improvements, but I want meaningful improvements that don't change the universal access of our system.

Your personal experience does not legitimize the entire medical system in Canada, I am sorry.

I'd like one of the richest countries on the planet not share a healthcare system only in common with North Korea and Cuba. But call me crazy.

[White Doors]

indeed it does, just look at the number of "unfixed" cats.

Seems people love a kitten, but heck, it's so cute and fuzzy and sweet.

BUT, no stopping them dumping the kittens in the country , or taking them to the humane society.

When they become to much of a nuisance.

Just pay to fix them, but the cost, the cost....

And how many people opt to put their pets down, when they require expensive treatments, because they cannot afford treatment?

Hmm, perhaps with privitization, we will see a swing upward in Euthansia.

Can't afford the treatment......

That should get the christian right up in arms, playing god and all..........

I guess more bad things have been done in the name of progress than any other. I myself have been guilty of this. When I was a teenager, I stole a car and drove it out into the desert and set it on fire. When the police showed up, I just shrugged and said, "Hey, progress." Boy, did I have a lot to learn

[Smallc]

I'd like one of the richest countries on the planet not share a healthcare system only in common with North Korea and Cuba. But call me crazy.

We don't share a system with them. We have private delivery and public funding already. That is why I'm not sure what will be accomplished by introducing proti to the system. It won't fix the nurse shortage, it won't fix the doctor shortage any faster than its fixing itself. Those are the two major problems, so I'm not sure what private enterprise can fix.

Your dislike of the system based on ideological grounds doesn't make it any less legitimate. Improvements are needed to the system, and improvements are being made. More imporvents are needed, and we need to make them. They should start coming faster with the Building Canada plan in terms of equipment.

[White Doors]

Let's face it, the objections to Medicare are ideological. The system has its problems, but then again, every single health care system in the Industrialized world is having problems due to aging populations. Among the more Libertarian Conservatives, there has always been a hatred of Medicare, and now they're latching on to every single problem and claiming the system is collapsing. That's just utterly bogus. If private systems or private-public systems worked, then the US and Great Britain would be paragons of health care virtue, but in fact, their systems have all sorts of systemic problems.

The Libertarians in the conservative movement want to deceive Canadians into throwing the baby out with the bathwater. That's what "starting over" really means, it means destroying Medicare and restoring the old system. I'm sure they'll go along with throwing tax credits and such at lower income Canadians, but let's remember, Medicare is universal, health care "gift cards" can be rescinded at any time.

oohhh!!! scary!

boo!

essentially, that is all you are saying. Point in fact, no one here advocated getting rid of universal access at all.

That just goes to prove that you are unable to have a rational discussion about it.

[Smallc]

No, of course not. Which is why I, and others here who are advocating for increased private involvement are not using the USA as an example. It's to the other extreme.

I was responding to the allegations that the veterinary medicine system in Canada is better. That is what I was talking about. I realize it isn't what you advocate, but it is what I was responding to.

[Canadian Blue]

Yeah, I want improvements, but I want meaningful improvements that don't change the universal access of our system.

Improvements? I don't know, that sounds like American talk.

Let's face it, the objections to Medicare are ideological.

Which is why all of the people on here for Medicare always yell "AMERICAN" when anyone criticizes the way the system currently functions.

If private systems or private-public systems worked, then the US and Great Britain would be paragons of health care virtue, but in fact, their systems have all sorts of systemic problems.

Great Britian, are you seriously suggesting that the NHS is an example of privatized healthcare. Seriously dude, you should try learning more about the world, like Singapore or Netherlands.

The Libertarians in the conservative movement want to deceive Canadians into throwing the baby out with the bathwater.

Not really, the only people who are trying to deceive Canadian's are those who defend are system by using anti-American sentiments as an excuse for mediocrity.

That's what "starting over" really means, it means destroying Medicare and restoring the old system.

No, it means actually looking at what other countries do when it comes to healthcare. Unlike you we are more internationalist in perspective and read about countries other than the United States.

I'm sure they'll go along with throwing tax credits and such at lower income Canadians, but let's remember, Medicare is universal, health care "gift cards" can be rescinded at any time.

Odd, I could have sworn most countries with universal healthcare have some degree of private for profit medicine. Perhaps all of us evil libertarians don't want to kill old ladies like you suggest.

[White Doors]

We don't share a system with them. We have private delivery and public funding already. That is why I'm not sure what will be accomplished by introducing proti to the system. It won't fix the nurse shortage, it won't fix the doctor shortage any faster than its fixing itself. Those are the two major problems, so I'm not sure what private enterprise can fix.

Your dislike of the system based on ideological grounds doesn't make it any less legitimate. Improvements are needed to the system, and improvements are being made. More imporvents are needed, and we need to make them. They should start coming faster with the Building Canada plan in terms of equipment.

I don't have any ideaological grounds about not liking the system smallc. I dislike your and other people's ideaology that prevent me and my family from getting the best health care possible because you may not agree with which the means that I get it.

The Quebec supreme court already decided that that was unconstitutional. Oh, not only do they agree with me, so does the Association of Canadian Dr's. In fact, they want to go further than I do. You see? You are the one with the ideaological blinders on and your attitude is the precise reason that medical care in Canada is in such poor shape.

ps: If there were more jobs available for Dr's and Nurses in Canada, it may bring back alot of the Medical practitioners who left by the boatloads in the 80's 90's and early millenium. Of course, not sure that you would be old enough to recall that.

[ToadBrother]

oohhh!!! scary!

boo!

essentially, that is all you are saying. Point in fact, no one here advocated getting rid of universal access at all.

That just goes to prove that you are unable to have a rational discussion about it.

The fact is I don't believe you. It's that simple. I think the Libertarians in the Conservative party and other right-wing organizations have long despised Medicare.

Canada wants, no not wants, has commanded its government to provide Medicare. That has not changed. The public will is clear, and the government has no choice, no matter what some crazy uber-right-wing think tanks want to believe. This is a democracy, that means pro-Medicare wins and you lose. Now, deal with that and then let's figure out how to really solve the problem by encouraging lots and lots of babies.

[White Doors]

I was responding to the allegations that the veterinary medicine system in Canada is better. That is what I was talking about. I realize it isn't what you advocate, but it is what I was responding to.

My cat was able to get a cat scan the same day I took him in for a check-up. My mother had to wait 4 months to get one to discover an aneurism in her brain.

Do you think I would give one flying fuck about how much money that would have cost to get my mother in the same day, like my fucking cat?

Do you see what we were meaning now?

[Smallc]

ps: If there were more jobs available for Dr's and Nurses in Canada, it may bring back alot of the Medical practitioners who left by the boatloads in the 80's 90's and early millenium. Of course, not sure that you would be old enough to recall that.

There are jobs available....the problem is the shortage exists across the western world. Many of those doctors and nurses were fired by governments of all stripes in the 90s. We can't change the past, but we can work on the future. The direction we take has to be smart though, not knee jerk.

[Michael Hardner]

TB,

No it's not. That's a lovely fiction, but the financial scandals show A. businesses and rating agencies can get into bed together to deceive investors and customers, B. price collusion, C. fundamentally, there's little accountability to individual investors, unless they are large investors.

Yes, that happens but every system fails. It's unrealistic to demand perfection. That sure isn't reason enough to reject a private inclusion in the system.

So what you're suggesting is the American model. For the poor folks there will be some sort up-front credit. Is that it?

Not at all. I'm suggesting that the government set all rates and pay out as happens today, but with more private management of the system overall. Or at least, some kind of new arm's length relationship between government and management.

Will the system still be available to all Canadians? Will hospitals be forbidden from turning away people because they can't pay, or not doing procedures for that reason? Right now, the electorate has a direct voice by the ability to throw out a government if it screws up, how would we retain that power in your system? Would contracts be limited to the term of the Provincial governments, with contracts renegotiated after each election?

That ability to throw out a government if it screws up is a false ability. The public doesn't have much choice from one government to the next. The system continues much as it always does.

The system should be effectively the same as it has been.

It's hardly failed. My wife still got her cancer treatments. Her life was saved, and we didn't go bankrupt in the process. What else can I ask from a health system?

Because it worked for you then the system is good ? That's not a high enough bar.

The fact that no can ultimately say how we're doing is proof that the system needs rework. There is no method for improvement, and the public is disconnected from the process.

Surely we can monitor without private contractors, no?

If so, then I'd love to see that happen. Explain to me how it would happen. My experience in business says that when things reach this level of complexity it's much easier to start fresh. This is what GM did with Saturn.

I didn't say the profit motive was invalid, I'm saying that business can be no better and in some cases much worse. If a health contractor goes bankrupt, where do we sit then? The government would essentially still have to underwrite, so in effect, we have a worthless middle man skimming profits, likely by cutting corners, paying inadequate wages to support staff, trying to move more and more essential services to the non-essential side.

The issue of inadequate wages is kind of a side issue. The issue should be about delivering better health care. That should be the priority. If a janitor gets hired along the way who is not a union member then so be it.

Start slashing the management massively, start centralizing health service, and not just the way it was done here in BC, where yet again, one level of bureaucracy was simply replaced by another even less accountable level of bureaucracy.

It sounds easy but it's not. Like I say, something new needs to be done.

I don't see how making the electorate even less capable of making its will known is an improving of accountability.

The electorate is incapable of this now. There are some ways that this could improve with a private provider. Maybe just the fact that it will be watched more closely will help things.

How do you plan for a major drop off in front-end revenues? The only ways I know are either to increase taxes or to decrease services. I suspect efficiencies will only get you part of the way, and not very far at that. I doubt the system is so inefficient that we can simply reorganize ourselves back into shape.

Again, I don't know why you doubt that. There isn't enough information for us to say. All we have is stakeholder associations telling us "our members are swamped".

Where in this does the public will come in? Canadians have made it clear, they want Medicare. All the rhetoric from the conservative think-tanks in the world won't change the facts.

I don't support purely private healthcare. I think 2-tiered healthcare would be a disaster if implemented in our current environment of ignorance.

But we need to do something new, and create awareness around the issues and some private delivery would probably help this.

What I think we should do is simply start by telling the truth, that to maintain and upgrade our system, we're all going to ahve to pay more money. We can either do it on a user basis (user fees) or we can collectively throw our taxes into it. I hate taxes as much as the next guy, but I'd rather see my taxes go up than to have to fear getting sick and having some unaccountable contracted firm say "No, I'm sorry, you're credit card bounced, we won't admit you for surgery."

Why do we have to pay more money ? Where are the extra costs ? There are 'studies' on this but not enough collective discussion of how to fix things. If the reasons were monitored and presented to us as raw data then we wouldn't have to rely on interlopers to tell us what's happening.

This is the mandate of the CIHI currently, however they only produce 'reports' not ongoing graphs of healthcare performance. Consumers need to start acting like customers and shareholders and demanding better.

[Canadian Blue]

I was responding to the allegations that the veterinary medicine system in Canada is better. That is what I was talking about. I realize it isn't what you advocate, but it is what I was responding to.

I was mocking many of the liberals on here who argue that they support a mediocre healthcare system simply because they don't want any reform that would allow competition.

Your dislike of the system based on ideological grounds doesn't make it any less legitimate. Improvements are needed to the system, and improvements are being made. More imporvents are needed, and we need to make them. They should start coming faster with the Building Canada plan in terms of equipment.

I've also heard that if we throw money into a giant hole and burn it we could bring about more infrastructure jobs. Let me ask you something, if I want to get an operation done and a doctor is willing to do it for a price why do you believe in taking away from the liberty of Canadian's to pay for medical care if they wish to get it.

You're entire argument thus far is that you don't want to be an American. I don't think you have any basis to say that people who support reform in the system are ideological when you base your arguments on a knee jerk anti-American sentiment instead of touting the benefits of a multi-layered bureaucracy over allow private health insurance.

[Smallc]

Do you think I would give one flying fuck about how much money that would have cost to get my mother in the same day, like my fucking cat?

Obviously, NB need to work on their system. I could get an urgently needed CT scan or even MRI right now in MB, SK, BC, AB, and probably ON. I could get heart surgery right now if I needed it. Each provinces system is different. They aren't all in trouble though they all have their own problems.

Edited December 17, 2008 by Smallc

[White Doors]

The fact is I don't believe you. It's that simple. I think the Libertarians in the Conservative party and other right-wing organizations have long despised Medicare.

Canada wants, no not wants, has commanded its government to provide Medicare. That has not changed. The public will is clear, and the government has no choice, no matter what some crazy uber-right-wing think tanks want to believe. This is a democracy, that means pro-Medicare wins and you lose. Now, deal with that and then let's figure out how to really solve the problem by encouraging lots and lots of babies.

hahaha.. Yeah, that's why the Quebec supreme court struck down Quebec's law's against private for profit healthcare.

Sorry, but your rabid dislike of business does not negate my RIGHT to take care of myself and my family. It's already started and is coming wether you like it or not.

So it is you who are going to have to get used to it, isn't it?

[Smallc]

It's already started and is coming whether you like it or not.

So it is you who are going to have to get used to it, isn't it?

I'll live with it, as long as in an emergency I can walk into say, a private hospital and get treated under public funding.

[White Doors]

Obviously, NB need to work on their system. I could get an urgently needed CT scan or even MRI right now in MB, SK, BC, AB, and probably ON. I could get heart surgery right now if I needed it. Each provinces system is different. They aren't all in trouble though they all have their own problems.

Really? I lived in Alberta for 11 years and never had a family Dr there. But you are right, I will take your word on it that the healthcare system in Alberta is peachy keen. Gee, you're right - I feel better already.

[ToadBrother]

hahaha.. Yeah, that's why the Quebec supreme court struck down Quebec's law's against private for profit healthcare.

The Quebec Supreme Court is not the electorate, and it's reasoning was that it was unreasonable to deny an individual access to private care if the public system could not provide it in a timely manner. It wasn't a carte blanche "Destroy the public system" ruling.

Sorry, but your rabid dislike of business does not negate my RIGHT to take care of myself and my family.

Blah blah blah. Libertarians are all the same "Society be damned, it's all about ME!" I have never seen a more poisonous anti-social ideology than Libertarianism.

It's already started and is coming wether you like it or not.

So it is you who are going to have to get used to it, isn't it?

The electorate has spoken. Ultimately even Klein backed down, and not because he needed Ottawas funding, but because Albertans are not keen to destroying Medicare.

[Smallc]

Really? I lived in Alberta for 11 years and never had a family Dr there. But you are right, I will take your word on it that the healthcare system in Alberta is peachy keen. Gee, you're right - I feel better already.

I get my information on the Alberta system from an Albertan. His mother had suspected cancer. She got a CT and MRI the next day and started treatment 3 days later. I never said the system was perfect, but it certainly isn't as bad as many make out.