Dear Bob

[Shady]

I would like to take back my original post. I don't think this letter should be mailed to the particular member in question. I don't even think this letter should be mailed at all. In fact, if anything, this letter should provide an opportunity for those of you who champion socialized government run healthcare for some introspection.

A one year wait time for an MRI, or similar tests is a direct result of socialized healthcare. It's people who religiously support the idea that only the government can be involved in providing healthcare services which lead to these long lines and frustrated patients. They're the same people who whine like stuck pigs whenever a private sector solution is offered as an option to remedy some of our healthcare problems.

It's why private health insurance is illegal in Canada. Why can't Canadian citizens be afforded the right to purchase supplemental health insurance? Why can't *gasp* private clinics provide some of long-lined services such as MRIs? It would accomplish two goals. One, cut the healhcare costs to government. And two, alleviate the log jam of people in public healh procedure lines, making wait times much shorter.

Some of you frustrated with the current system, need to look in the mirror. You've been part of the problem, not the solution.

[Michael Hardner]

Some of you frustrated with the current system, need to look in the mirror. You've been part of the problem, not the solution.

Shady, I concur with many of your points, however I submit that healthcare's failure isn't due to the funding model, but rather it's due to the fact that it's tied to politics for its administration. And furthermore, the stakeholders of healthcare - us - can't pay enough attention to the administration to keep it run properly.

Instead, we have money thrown at it, emotion-based debates about resource allocation, and a general moaning and grinding of teeth.

Another note: In the US, there's as much displeasure over their system which is structured differently from ours. Why is that ? I would say because our public forums are so similar.

[Shady]

Shady, I concur with many of your points, however I submit that healthcare's failure isn't due to the funding model, but rather it's due to the fact that it's tied to politics for its administration. And furthermore, the stakeholders of healthcare - us - can't pay enough attention to the administration to keep it run properly.

Instead, we have money thrown at it, emotion-based debates about resource allocation, and a general moaning and grinding of teeth.

Another note: In the US, there's as much displeasure over their system which is structured differently from ours. Why is that ? I would say because our public forums are so similar.

I agree and disagree with some of your points. I'm definitely not advocating for only a US style of healthcare. I just think that some private sector services and insurance should be part of our system. However, I do think part of our system's failure is the funding model. That, and the fact that nobody ever sees how much healthcare services actually cost. I think invoices should be given out to everybody that uses our system. People should know how much surgeries, tests, etc, actually cost, and that these things aren't really "free."

[Michael Hardner]

I agree and disagree with some of your points. I'm definitely not advocating for only a US style of healthcare. I just think that some private sector services and insurance should be part of our system. However, I do think part of our system's failure is the funding model. That, and the fact that nobody ever sees how much healthcare services actually cost. I think invoices should be given out to everybody that uses our system. People should know how much surgeries, tests, etc, actually cost, and that these things aren't really "free."

I agree that getting the costs out there - making people understand what they are is a big part of improving the services.

There are only advocate groups telling us what is going on. The exception is a group called the NIHI - National Institute for Health Information - but they are unknown to the general electorate and basically fall into the same flaws of communicating their findings as scientists: dry, arcane information that you have to seek out in order to inform yourself.

[Argus]

A one year wait time for an MRI, or similar tests is a direct result of socialized healthcare.

Shady, wrap your mind around the notion that there are not just two health care systems; ours and the Americans'. You don't wait a year for an MRI in France or Germany or Sweden, despite their socialized medicine. A one-year wait for an MRI is the direct result of incompetence by bureacrats and a near total lack of care by politicians combined with a lazy, stupid electorate who don't seem to realize that this sort of negligent incompetence is NOT the norm.

Let me suggest that if one day you tripped a switch and we went from the health care we had twenty five years ago - with minimal waits for serices, including ER attention, to the long waits we have now, there would be an uproar and the government in power would be slaughtered at the polls. However, it has crept up on people, year by year by year so that they're not outraged at 10 and 12 hour waits to get a broken bone treated. They shrug and say "oh well, what can you do" with a kind of resigned acceptance.

This infuriates me, but unfortunately, all too many people look at the US and ONLY the US, and say that our system is at least more equitable and more efficient than theirs. They're right, but that's a pretty damned low bar to pass. The US system is the most inneficient on the planet, bar none, and we need to ignore it and set our sights on more efficient, effective systems like those in Europe.

What we shouldn't do is act like a herd of sheep, and meekly accept what pasty-faced, useless political ferrets like McGuinty feed us, then go vote them back into office again. You're right in one thing only. Anyone who votes Liberal in Ontario has no right whatever to complain about the woeful health care system (or the rotten educational system for that matter).

The same goes federally. I despised the Liberals for a number of reasons, but one of the main one was how they allowed health care to deteriorate, all the while piling up huge surpluses, and did nothing to address its problems. I voted for the Tories in the hope they would do better. They haven't. Now part of that is, I know, because they're in a minority and the other parties will react with knee-jerk outrage to any changes to the system. Hell, Stockwell Day was reduced in frustration to holding up a sign during the debates to emphasise that they were commited to public health care.

And the opposition have been sitting back like vultures over a dying man, eagerly waiting, almost salivating for the first hint from the Tories that they want to do any substantive changes to the Canada health act. At which point all of them will start howling and screaming "American health care! They're bringing in American health care! They want your children to die in the street!" Don't kid yourself. I've seen not a single hint from any of them that they even recognize the health care system needs major changes, let alone that they have any ideas for changing it. So I don't expect anything from them.

I think the Tories are underestimating the desire for change, though. I think they could go for major changes to the health care system and if it's carefully changed and explained they could get their majority on it (which they would need for the opposition would certainly bring the government down if it tried anything to change the system). Unfortunately, the Tories are to communication what the US govermment is to balanced budgets. That is, a freaking disaster. If there's anyone in that party who knows how to put a coherent message out to the public they have not made their presence known in the last ten years.

Edited March 6, 2010 by Argus

[bloodyminded]

Shady, wrap your mind around the notion that there are not just two health care systems; ours and the Americans'. You don't wait a year for an MRI in France or Germany or Sweden, despite their socialized medicine. A one-year wait for an MRI is the direct result of incompetence by bureacrats and a near total lack of care by politicians combined with a lazy, stupid electorate who don't seem to realize that this sort of negligent incompetence is NOT the norm.

Let me suggest that if one day you tripped a switch and we went from the health care we had twenty five years ago - with minimal waits for serices, including ER attention, to the long waits we have now, there would be an uproar and the government in power would be slaughtered at the polls. However, it has crept up on people, year by year by year so that they're not outraged at 10 and 12 hour waits to get a broken bone treated. They shrug and say "oh well, what can you do" with a kind of resigned acceptance.

This infuriates me, but unfortunately, all too many people look at the US and ONLY the US, and say that our system is at least more equitable and more efficient than theirs. They're right, but that's a pretty damned low bar to pass. The US system is the most inneficient on the planet, bar none, and we need to ignore it and set our sights on more efficient, effective systems like those in Europe.

What we shouldn't do is act like a herd of sheep, and meekly accept what pasty-faced, useless political ferrets like McGuinty feed us, then go vote them back into office again. You're right in one thing only. Anyone who votes Liberal in Ontario has no right whatever to complain about the woeful health care system (or the rotten educational system for that matter).

The same goes federally. I despised the Liberals for a number of reasons, but one of the main one was how they allowed health care to deteriorate, all the while piling up huge surpluses, and did nothing to address its problems. I voted for the Tories in the hope they would do better. They haven't. Now part of that is, I know, because they're in a minority and the other parties will react with knee-jerk outrage to any changes to the system. Hell, Stockwell Day was reduced in frustration to holding up a sign during the debates to emphasise that they were commited to public health care.

And the opposition have been sitting back like vultures over a dying man, eagerly waiting, almost salivating for the first hint from the Tories that they want to do any substantive changes to the Canada health act. At which point all of them will start howling and screaming "American health care! They're bringing in American health care! They want your children to die in the street!" Don't kid yourself. I've seen not a single hint from any of them that they even recognize the health care system needs major changes, let alone that they have any ideas for changing it. So I don't expect anything from them.

I think the Tories are underestimating the desire for change, though. I think they could go for major changes to the health care system and if it's carefully changed and explained they could get their majority on it (which they would need for the opposition would certainly bring the government down if it tried anything to change the system). Unfortunately, the Tories are to communication what the US govermment is to balanced budgets. That is, a freaking disaster. If there's anyone in that party who knows how to put a coherent message out to the public they have not made their presence known in the last ten years.

Very nicely said.

[Smallc]

Shady, wrap your mind around the notion that there are not just two health care systems; ours and the Americans'. You don't wait a year for an MRI in France or Germany or Sweden,

Well, you don't have to wait that long in most provinces either.

[Argus]

Well, you don't have to wait that long in most provinces either.

No, but other provinces have their own sytems failings. Look at Quebec. This is the most left wing province in Canada, and it spends more per capita on social programs, I believe, than any other province. What does it get them in the way of health care? It's so bad across the river that Quebecers come to Ottawa in droves to get better, more timely health care. It's not merely the long waits over there, either, longer by far than in Ottawa, but at least a perception among most Quebecers I know that incompetence is, if not exactly tolerated, certainly widespread within their health care systems.

In many cases across the country, the problems are fairly similar. They start with inadequate elderly care in every province. That leads to sick seniors crowding hospitals and filling up beds. How many provincial governments have made much of an effort to address this issue, though? It's not a matter of money. It costs FAR more money to put seniors up in hospitals than it would to keep an eye on their health on an ongoing basis and treat problems before they get out of hand. It costs FAR more money to keep inform seniors in hospitals than it would to build a freaking nursing home and transfer them all into it. Do a cost benefits analyses of the cost of all the seniors crowding the hospital beds in Ottawa vs the costs if they were all in a nursing home, or better yet, being given adequate home care. It just doesn't compare. So why aren't there shovels in the ground building a bunch of nursing and seniors residences? With billions spend on incentives across the province why didn't they decide to funnel a billion or so into building seniors residences?

[Shady]

You don't wait a year for an MRI in France or Germany or Sweden, despite their socialized medicine.

Actually, a system like France or Germany would be much more efficient. They have hybrid systems, that encompass both public and private health delivery services. Unfortunately, the public healthcare nazis in Canada, won't allow real dicussion regarding private services, let alone allow for real reform.

You're quite right. They scream "American style healthcare" and drown out real debate.

Edited March 6, 2010 by Shady

[Smallc]

No, but other provinces have their own sytems failings.

Every system has it's failings. They are, after all, systems developed by humans. The question is, are the problems getting worse or better. The answer, depends on which province you live in and often what part of the province you live in. Generally, the problem isn't really one, because doctors are good at deciding who needs care more than others.

The problems we have in Canada are being felt everywhere, because there is a shortage of medical professionals the world over. I welcome private care under the public umbrella. I welcome private options for some limited things (like diagnostic imagery), but I don't welcome the introduction of widespread private care. All it will do is steal people from the provincial systems.

Edited March 6, 2010 by Smallc

[bush_cheney2004]

.... All it will do is steal people from the provincial systems.

This implies that the "provincial systems" own "people"....but they don't.

Edited March 7, 2010 by bush_cheney2004

[Smallc]

This implies that the "provincial systems" own "people"....but they don't.

No, they don't but they do have to compete with all of the rest of the world. Having to compete within Canada would most likely make things worse.

[bush_cheney2004]

No, they don't but they do have to compete with all of the rest of the world. Having to compete within Canada would most likely make things worse.

Sure...we all know that competition never makes things better. [/sarcasm]

[Smallc]

A system that would serve only relatively wealthy to wealthy people competing with and making less effective a system that has to serve everyone. Right now, we have a good thing. Anyone who wants to, can go pay for procedures in the US. Right now, anyone who wants to can buy wait time insurance. Right now, anyone who wishes to stay and use our system will get good service, though some select things take to long. The only advantage that I can see to widespread private care in Canada is the fact that it would keep the small amount of healthcare spending that leaves the country here....maybe.

[Argus]

No, they don't but they do have to compete with all of the rest of the world. Having to compete within Canada would most likely make things worse.

If there aren't enough doctors and nurses in Canada that is due entirely to the incompetence and lack of care shown by federal and provincial governments. It has nothing to do with competition.

The number of spaces available to train doctors and nurses is restricted by government. It could, at any time, increase the number of spaces in medical programs but has chosen not to. In addition, the number of spaces available in hospitals for interns is restricted to a certain degree by the availabilty of said positions. From what I underestand, a large number of such spaces are sold by the hospitals to foreign governments so that foreign students can intern here and then return home to practice. That too, is within the government's control, and it has not chosen to do anything about it.

[Smallc]

If there aren't enough doctors and nurses in Canada that is due entirely to the incompetence and lack of care shown by federal and provincial governments. It has nothing to do with competition.

The number of spaces available to train doctors and nurses is restricted by government. It could, at any time, increase the number of spaces in medical programs but has chosen not to.

Again, speak for your own province, not mine. Every year over the last 10 years, my province has added doctors and nurses at more than double the rate of population growth after years of PC mismanagement. They did this through aggressive foreign recruiting and an increase in training spaces almost every one of those years. The 4 month maximum wait for MRI scans in manitoba should fall back to the less than 2 month number that it was in 2007 in not that long because for the first time, there will be Manitoba trained MRI technicians available. Don't assume that the public in other provinces aren't holding their governments to account on healthcare just because Ontarians aren't.

Edited March 7, 2010 by Smallc

[Michael Hardner]

Every system has it's failings. They are, after all, systems developed by humans. The question is, are the problems getting worse or better. The answer, depends on which province you live in and often what part of the province you live in. Generally, the problem isn't really one, because doctors are good at deciding who needs care more than others.

The problems we have in Canada are being felt everywhere, because there is a shortage of medical professionals the world over. I welcome private care under the public umbrella. I welcome private options for some limited things (like diagnostic imagery), but I don't welcome the introduction of widespread private care. All it will do is steal people from the provincial systems.

"Are the problems getting worse or better ?"

Indeed that is the question. And I have asked many people, people who are politically aware, who work in business and are well educated, where they would go for information on our health systems. Their answer is invariably: "Google".

If I asked where they would go for sports scores, people would say "the sports page" or "NHL.com" but for healthcare information, nobody has a clue even where the statistics our posted. As our political systems continue to become attuned to mass media coverage, the performance of services becomes neglected. We are stakeholders in our healthcare systems, like shareholders in a large company, and yet we have no effective reporting.

Even the private/public debate doesn't directly address the problem that people don't pay attention to how our systems are managed.

Edited March 7, 2010 by Michael Hardner

[Michael Hardner]

If there aren't enough doctors and nurses in Canada that is due entirely to the incompetence and lack of care shown by federal and provincial governments. It has nothing to do with competition.

The number of spaces available to train doctors and nurses is restricted by government. It could, at any time, increase the number of spaces in medical programs but has chosen not to. In addition, the number of spaces available in hospitals for interns is restricted to a certain degree by the availabilty of said positions. From what I underestand, a large number of such spaces are sold by the hospitals to foreign governments so that foreign students can intern here and then return home to practice. That too, is within the government's control, and it has not chosen to do anything about it.

This is yet another fact that is poorly understood. And where are the shortages ? I thought we were short of General Practioners too ?

[Argus]

This is yet another fact that is poorly understood. And where are the shortages ? I thought we were short of General Practioners too ?

We are short of every type of doctor, yet we don't make much effort to train more.

In 2009, there were almost 5,000 qualified applicants to the Michael G. DeGroote School of Medicine at McMaster University in Hamilton alone. Only 194 were accepted. At Dalhousie University Faculty of Medicine in Halifax, only 102 of almost 700 applicants made it in. It's something that happens at med schools across the country every year.

Many qualified, few get into medical schools

[Smallc]

According to some studies I've seen, we're now training enough medical students going forward, it will simply take time to catch up to where we need to be.

[Topaz]

According to some studies I've seen, we're now training enough medical students going forward, it will simply take time to catch up to where we need to be.

[/quote

]Yeah, by that time us, babyboomers will be dead and they will be too many doctors. Can there be too many doctors? Sounds like in Ottawa there too many VIP's standing in line ahead of the rest of you or not enough MRI machines.

[Argus]

According to some studies I've seen, we're now training enough medical students going forward, it will simply take time to catch up to where we need to be.

Do you have a cite on that? Because I have not heard anyone saying "Okay, end of problem. We don't need to worry any more about doctor shortages. It's taken care of."

[Smallc]

It was on CBC a few months ago, and I don't know if I can find it.