Why can't politicans talk about serious healthcare fixes?

[pfezziwig]

Yet another report highlighting Canadians dissatisfaction with their public healthcare services was released by Angus Reid (large random sample of 55k across canada).

Is there anyone left in Canada who thinks healthcare services are going to get better in the future?

Why are politicans afraid to support the private sector healthcare providers as a solution to unsustainable public healthcare costs? Do unions frighten them so much that they would rather watch our healthcare services decline instead of confronting them with private sector solutions? Or is it delusional Canadian voters who believe more public spending is the solution that they fear more, I suspect it's a little of both.

The last 30 years of deficit spending was not a long term viable strategy, let's encourage our politicians to talk about the elephant in the room, they need some encouragement and support.

Looking forward to some replies from canadians who think more public spending is the solution, or 'trimming the fat' and making the public sector more efficient will solve our public healthcare problems in the long run

[bjre]

Is there anyone left in Canada who thinks healthcare services are going to get better in the future?

No, I don't, because interest groups want money, politicians can not be elected if they don't make those interest groups happy, because they control the main stream media.

[Zachary Young]

Politicians blab on about how our health care system is the best in the world, but if any of them have a serious medical issue they are the first to take flight. Now I think the original poster here is right on the money. Personally I favour the abolition of OHIP, I think $4000 a year for every man woman and child in my province is too high a cost to pay. Socialism doesn't work, never has, never will, and all the left wing advocacy groups in the world won't change that basic reality. None the less the political will is not present to put an end to this program just yet. Eventually this will change of course and the system as we know it will collapse, after all you can't just keep dumping taxpayer dollars into a broken system and expect this to hold together forever. What we need to do, as concerned citizens, is to agitate for a workable private system so that when the collapse comes the medical infastructure to handle our needs is already in place.

Specifically we need a completely free market in health care. No taxes or regulations on it, no system of licensing, simply if anyone wishes to open up a practice they should be free to. Should a doctor trained in India move to this country he should be able to open up shop immediately. Or a nurse who has been delivering health care for years, if she wants to open up her own private practice who are we to refuse? Simply get government out of the way and allow the market to work.

[Sir Bandelot]

You are correct, there are problems. However we don't want to go from the frying pan into the fire. Our system is having difficulties, but so is every system in the world. The problem is not about the type of system, it's about corruption. Wherever there is a lot of money, that's where you'll find criminal activity. And healthcare is one of those places. and no matter what system is put in place, the problem of gouging the public for money will continue.

I've worked in the health care system for decades, and observed it, analyzed why it works the way it does. I can say the health care workers themselves are the most dedicated people I know. The problem really begins in hospital management, and extends upward right into the government.

I believe in our case, completely changing the system will only make it worse. There are no major gains to be made in going private. And most of the efficiency at the front line has been attained, nothing more to gain. It's absurd to cut back services at this point. The problem is corruption and it points to a much larger problem in our society as a whole, we've come to this point where everything costs huge and we are not effective at getting things done. Whatever we build is not made to last, compared to the 1950's.

Edited December 7, 2010 by Sir Bandelot

[Michael Hardner]

The problem that the discussion always breaks down to a familiar left-vs-right debate. The issues of management of services are too complicated to keep the attention of a broad audience.

There needs to be a new public created, that can discuss the issues of service and how best to address problems. That's no small task.

As it is, when the debate comes up it's always about privatization, which turns into an emotional discussion. As a result, the debate goes nowhere and the system continues to (or maybe appears to) deteriorate.

If we don't want a market system for healthcare, to keep it efficient, then we have to replace the current political management of the system with something that's more independent of politics.

[bjre]

The problem that the discussion always breaks down to a familiar left-vs-right debate. The issues of management of services are too complicated to keep the attention of a broad audience.

There needs to be a new public created, that can discuss the issues of service and how best to address problems. That's no small task.

As it is, when the debate comes up it's always about privatization, which turns into an emotional discussion. As a result, the debate goes nowhere and the system continues to (or maybe appears to) deteriorate.

If we don't want a market system for healthcare, to keep it efficient, then we have to replace the current political management of the system with something that's more independent of politics.

I talked about this before. I believe the monopoly is the reason that makes competition impossible. When all license abolished, anyone from any place can be a doctor, let the patients choose their trusted doctors themselves, it will be a free market, the problem automatically solved. But this will make the existing money robbers unhappy.

Edited December 7, 2010 by bjre

[Zachary Young]

When confronted with the failure of a socialist system, advocates often attempt to place the blame on the managers in charge. Ludwig von Mises in his landmark work 'Socialism' laid out the case succinctly. In the absence of a price structure it is impossible to achieve accurate economic calculation. That is to say that bureaucrats can never replace the role of entrepreneur in the economy. They simply will never be able. The problem with our health care is systemic, you cannot simply replace the people in charge and expect things to work better because no one can do by fiat what the market does.

There is no such thing as a free lunch. Things cost money. You cannot avoid this fact by putting this institution named government in the middle of an extremely complicated market, all you are going to do is introduce massive inefficiencies and distortions of the market which will drive price up and quality down. Take for example this idea of making health care zero cost to the end user. Well what is going to be the natural result of this? It is going to drive up demand. When price is zero demand is infinite. And politicans respond to us "well don't be so greedy and stop using health care!!". This is the solution of bureaucrats. An entrepreneur looks at a spike in demand as an opportunity to make some money and gets busy implementing solutions, but bureaucrats respond by RATIONING THE SERVICE. THIS MEANS PEOPLE DIE.

There is nothing unique about the health care market that makes it more suited for socialism than any other. Capitalism is the only answer. So long as we have a socialist system costs will skyrocket, quality will decline and people will die relative to what would exist in a free market system. Of course owing to technologies developed in freer markets and general increases in standard of living owing to the productive efforts of a great many people our health care system will continue to improve, but if you could only understand what could be without the leviathon ruining everything, what a free society could look like, you would cry yourself to sleep understanding the harm that has been done by the state.

[Michael Hardner]

When confronted with the failure of a socialist system, advocates often attempt to place the blame on the managers in charge. Ludwig von Mises in his landmark work 'Socialism' laid out the case succinctly. In the absence of a price structure it is impossible to achieve accurate economic calculation. That is to say that bureaucrats can never replace the role of entrepreneur in the economy. They simply will never be able. The problem with our health care is systemic, you cannot simply replace the people in charge and expect things to work better because no one can do by fiat what the market does.

Never is a long time away. To say never is to say that the nature of an economy never changes, so I think that's a cop out. The market provides price information, as one of its functions, and to say that that information hasn't changed in the last 50 years is just incorrect.

There is no such thing as a free lunch. Things cost money. You cannot avoid this fact by putting this institution named government in the middle of an extremely complicated market, all you are going to do is introduce massive inefficiencies and distortions of the market which will drive price up and quality down. Take for example this idea of making health care zero cost to the end user. Well what is going to be the natural result of this? It is going to drive up demand. When price is zero demand is infinite. And politicans respond to us "well don't be so greedy and stop using health care!!". This is the solution of bureaucrats. An entrepreneur looks at a spike in demand as an opportunity to make some money and gets busy implementing solutions, but bureaucrats respond by RATIONING THE SERVICE. THIS MEANS PEOPLE DIE.

Health care will never be zero cost, so I don't know where that comes from.

There is nothing unique about the health care market that makes it more suited for socialism than any other. Capitalism is the only answer. So long as we have a socialist system costs will skyrocket, quality will decline and people will die relative to what would exist in a free market system. Of course owing to technologies developed in freer markets and general increases in standard of living owing to the productive efforts of a great many people our health care system will continue to improve, but if you could only understand what could be without the leviathon ruining everything, what a free society could look like, you would cry yourself to sleep understanding the harm that has been done by the state.

There is something unique about the health care market. It's highly specialized, and these services are essential to life as much as food and water are - but are much more difficult to manage than water or food distribution.

I agree that the leviathon needs to change, but as has been pointed out - a complete destruction of the system wouldn't be helpful.

We need practical people to discuss this, and to talk about how to achieve improvement in a practical way, ignoring the fundamentalist economic dogmas of extreme right and left. That, as I said, is the problem. People try to tie healthcare in with universal philosophies of economics and politics. In fact, the system is both socialistic and capitalistic now, so iterative change along the same lines is desirable and practical.

[Zachary Young]

Excuse me for using economic theory to inform my opinions, maybe I should just pull things out of my ass like everyone else?

[Oleg Bach]

Excuse me for using economic theory to inform my opinions, maybe I should just pull things out of my ass like everyone else?

Here is a chunk I will pull out..I visited Saint Michael's cardiac ward last night - I was impressed by how beautiful an innner city hospital could be..I was expecting a run down core of the city Americanish dump of a facility...but - as I visited my friend and took a quick look around _ I came to the realization that the most common person in Canada - can have the same level of care as the President of the Unitied States gets....now that is impressive.

[Topaz]

When it comes to health care, we don't have to worry about the rich and private health care. They can go where ever they want to be treated. Its the middle-class and down that needs the provincial health system. We need someone to monitor more closely where the money is going and the thoughts of the patients and their treatments so we can fixed what needs to be fixed. I would think health care will see a easying after the boomers are gone.

[bjre]

Here is a chunk I will pull out..I visited Saint Michael's cardiac ward last night - I was impressed by how beautiful an innner city hospital could be..I was expecting a run down core of the city Americanish dump of a facility...but - as I visited my friend and took a quick look around _ I came to the realization that the most common person in Canada - can have the same level of care as the President of the Unitied States gets....now that is impressive.

When my wife in a hospital for a baby, in the surgery room, there was only one doctor, and one old lady as a nurse.

That night, she had 4 room mates.

Regular waiting time for Emergency is more than 10 hours in most Toronto hospitals.

Family doctor waiting time need to be 1 hour and need appointment.

Walk in clinics does not open door until 10am.

Congratulation president Oleg.

[Shwa]

Excuse me for using economic theory to inform my opinions, maybe I should just pull things out of my ass like everyone else?

How quaint. You mean "economic theory" like this:

... Socialism doesn't work, never has, never will, and all the left wing advocacy groups in the world won't change that basic reality.

That sounds exactly like something pulled out of your ass. Like everyone else.

[Evening Star]

I was gonna say: I didn't know Ayn Rand was considered the pinnacle of economic theory these days. We have an example of a free market in health care south of the border (although I'm sure it's not free enough for Mr Young). It is more expensive and inefficient and leaves more of the population without adequate coverage without producing demonstrably better health outcomes. We also had a free market in health care in this country until 1965. Somehow, hardly anyone seems to advocate returning to it. Our system may leave some room for improvement but we should look at models of countries whose systems actually seem to work better in terms of health outcomes for the population. In some cases, a greater level of public involvement may help, e.g. in terms of bulk drug purchasing.

[bloodyminded]

Socialism doesn't work, never has, never will, and all the left wing advocacy groups in the world won't change that basic reality.

In terms of support for universal healthcare, these "left wing advocacy groups" make up the massively overwhelming majority of Canadians, who almost...well, universally support the idea.

Even elected leaders who would rather have a privatized system don't tend to float the idea...not out of fear of some powerful "left wing advocacy group," but out of fear of the voting public.

Those who say we should abolish the public system are actually calling for anti-democratic statism. Perhaps ironically, they're calling for Big Government to interfere with the clear democratic will.

Edited December 7, 2010 by bloodyminded

[Smallc]

Those who say we should abolish the public system are actually calling for anti-democratic statism. Perhaps ironically, they're calling for Big Government to interfere with the clear democratic will.

Yes, and, looking at the study, the parts we aren't happy with - hospital stays and emergency room visits - well, who is ever happy about what happens in those situations? Most of the people in the ER for example, probably shouldn't be there in the first place....and I've never known anyone, anywhere, who is satisfied to have to stay in a hospital.

That's not to say there aren't necessary improvements, but the idea that we are dissatisfied with the system, when other polls over the years have shown otherwise, really doesn't make any sense.

[Evening Star]

Yeah, now that I actually read about the actual poll, the picture seems a little different:

The poll also showed that once Canadians actually access specific health services, their overall satisfaction is considerably high -- with the exception of emergency room visits.

Of those who had recently visited a family doctor or general practitioner, nine out of 10 said they were satisfied, based on their last experience. Saskatchewan's score was the same as the national average.

Ninety per cent of Canadians who had recently visited a specialist were satisfied -- including 89 per cent of Saskatchewan respondents. And those who had an advanced diagnostic test, such as an MRI or CT scan, were also very satisfied; 91 per cent were satisfied nationally compared to 92 per cent in Saskatchewan.

Read more: http://www.thestarphoenix.com/health/Poll+finds+health+care+satisfaction/3937716/story.html#ixzz17SFnsPHh

This Angus Reid poll, also from this year, shows a majority of Canadians taking pride in the health care system: https://www.angusreidforum.com/mediaserver/3/documents/20100630_CanadaDay_EN.pdf+angus+reid+health+care&hl=en&gl=ca&pid=bl&srcid=ADGEESgM2NTtcK5E_UsnUM-gKE_TkrRVoAOxdLC4sAyiOOqIlX6UIh3U3gm3yVUhV-1l3ZmB16CHL6Y6tlJzUcZCHGFbT9brKEEzY-z_bS-UCBUzvrzX4FQ9eRs_V2TitZpsM38AZ8Fr&sig=AHIEtbTdUgdp-7ca71cdV4ladeG0RJaeEQ

And Smallc is right. Talk to some Americans about how satisfied they are with ER and hospital services.

[Evening Star]

This may work better for the 'pride' poll:

http://docs.google.com/viewer?a=v&q=cache:XOPJFzEbtqIJ:https://www.angusreidforum.com/mediaserver/3/documents/20100630_CanadaDay_EN.pdf+angus+reid+health+care&hl=en&gl=ca&pid=bl&srcid=ADGEESgM2NTtcK5E_UsnUM-gKE_TkrRVoAOxdLC4sAyiOOqIlX6UIh3U3gm3yVUhV-1l3ZmB16CHL6Y6tlJzUcZCHGFbT9brKEEzY-z_bS-UCBUzvrzX4FQ9eRs_V2TitZpsM38AZ8Fr&sig=AHIEtbTdUgdp-7ca71cdV4ladeG0RJaeEQ

(It's a bit fluffy, admittedly.)

[pfezziwig]

I'm not advocating the removal of the public healthcare system, just to allow the private to compete. It's a monopoly and the government are acting like thugs, strong arming anyone who wants to offer private sector services. We can still fund the public sector as much as we like (even if it is stolen from the future).

Picture this, politican 'Joe' promises to allow private sector hip replacement surgeries, thereby reducing year long waits for suffering seniors, and saving tax payer dollars. Would that not be a populist move? Are left wing Canadians that intolerant to not allow private sector services where they are terribly needed, like in this simple example? Or would these fanatics still vote 'Joe' out of office for doing this and make seniors suffer so they can make their point?

[fellowtraveller]

Is there anyone left in Canada who thinks healthcare services are going to get better in the future?

Sure, there are plenty that think just that and are willing to fight to at least maintain the status quo. It is impossible of course to maintain even that- the demographics, cost of technology, early retirement ages and longer lifespans all mean that we cannot continue to spend at this ever increasing rate. Many provinces spend nearly 50% of their revenue on health care now, if this continues unchecked we will spend all tax money on it soon enough. And we will all still die even then.

What is really disheartening is that even this late in the game, we are unable to have a reasoned discussion about health care in Canada. Without a doubt, there will have to be many things delisted and not covered by the public purse. Without a doubt, services must be provided by whatever agency can do it cheapest. And none of that will be nearly enough to keep everybody alive forever.

The % will be capped, and life altering and life ending decisions will be made within that cap. It is inevitable. Someday we will jointly have the gumption to talk about it, but it is not today or tomorrow.

[Michael Hardner]

Excuse me for using economic theory to inform my opinions, maybe I should just pull things out of my ass like everyone else?

It's not economic theory that sidelines the debate, it's economic zealotry. Von Mises and Marx have to sit on the sidelines for this one. If you want to dynamite the system and start over, start a new country. It's not practical.

[madmax]

I enjoy reading alot of bad ideas...

[Battletoads]

A private sector healthcare solutions to fight rising costs? Now there's an oxymoron.

The best hope for the Canadian Medicare system is to vote out those who opposes the system and want it to fail (see conservatives).

[jbg]

Looking forward to some replies from canadians who think more public spending is the solution, or 'trimming the fat' and making the public sector more efficient will solve our public healthcare problems in the long run

There's an elephant hiding in the room in both of our countries.

Many people are surviving well into their 90's and even early 100's. They're working a little bit longer than before, but not 20 years longer. We cannot, as a society, afford tohave people not working for about half their life span, i.e. 0-25 and 65-95. It's that simple.

[Guest TrueMetis]

One of the biggest solutions is to increase the retirement age, and what do you think is going to happen to the first politician to suggest that? It won't be pretty.