Why can't politicans talk about serious healthcare fixes?

[Evening Star]

I actually strongly favour increasing the retirement age.

[Evening Star]

Otherwise, I don't think that these points, most of them valid, are necessarily an argument for privatization or even a two-tier system. Costs will rise but they will have to be paid by us somehow. If they're not distributed via taxation and public spending, they will just be dumped on unfortunate seniors and their families. I'm not 100% opposed in principle to allowing private competition in some areas (although I'd actually be more interested in seeing expanded OHIP for things like dental and eye care) but is there evidence to show that this would actually reduce costs? Costs are higher in the American private system.

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.

[Guest TrueMetis]

I actually strongly favour increasing the retirement age.

As do I but I have the feeling most people will not. I just can't imagine spending 20 years doing nothing, cause you know they haven't saved up enough money to actually do anything. Most people probably haven't saved up enough to even survive that long.

[August1991]

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

Instead, you take ideas from a polemicist who died almost 40 years ago.

ZY, I am probably more libertarian than you but even I recognize that the health market is not a simple question of supply and demand. Most patients do not have adequate information about their situation and doctors have an incentive to abuse their knowledge. For patients, the market is fraught with fear.

ZY, how old are you? When you are old and ill, come back and post here about von Mises and health care.

Edited December 8, 2010 by August1991

[Bonam]

As do I but I have the feeling most people will not. I just can't imagine spending 20 years doing nothing, cause you know they haven't saved up enough money to actually do anything. Most people probably haven't saved up enough to even survive that long.

The whole idea of a "retirement age" seems quite silly to me. I plan to still be working in my field and enjoying it when I'm 120.

[wyly]

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.

you have no clue...

[wyly]

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.

yup, it's the politicians that f*** it up...

[wyly]

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

as it relates to healthcare it is coming out of your arse...

[Guest TrueMetis]

The whole idea of a "retirement age" seems quite silly to me. I plan to still be working in my field and enjoying it when I'm 120.

As do I, of course that assumes I get into said field. A lot can happen in the next century before I turn 120.

[wyly]

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's how it should be in a normal birth, that old lady could probably deliver the baby without the MD...a MD, Nurse, wife and me for our first born and 17 for my twins with potential complications...

That night, she had 4 room mates.

normal, there is always the option for semi and private if you pay...we paid and she had a private room every time...

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

go persuade some MDs to open more walk-in clinics...

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

they are...

Walk in clinics does not open door until 10am.

the walk in clinics I'm familar with are all private they can open whatever time they wish...maybe you should have a talk with them...

[wyly]

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).

so taking MDs out of the system is going to reduce wait times? only for the wealthy, for everyone else they will get longer...

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?

really unless there was an accident where the seniors got hurt the wait is their own fault(and if there was an accident they go to the top of the wait list), hip and knee replacements don't suddenly occur these are long term disabilities these people have been avoiding surgery for a long time before they made a date with the surgeon...I need a new knee, my surgeon says just call his office when I want to book a time but knowing me I'll wait until I can hardly walk before I do, so the extra pain I go through will be my fault not that of the healthcare system...

[wyly]

As do I but I have the feeling most people will not. I just can't imagine spending 20 years doing nothing, cause you know they haven't saved up enough money to actually do anything. Most people probably haven't saved up enough to even survive that long.

I don't plan to retire, slow down certianly...I've a more than a few family members still working full time in their 70's...

and according to my MD buddies when you stop working you start dying... the brain and body need to stay active and challenged...

[bloodyminded]

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.

Your use of both these names is highly apt.

There are Marxists who apparently believe that everything falls under the rubric of their favoured "ism," if we could only suss out and "practically apply" the Great Man's theories.

Those who summon von Mises as having such a perfect theoretical framework that it can always be applied to all present and future circumstances are making precisely the same error.

[bloodyminded]

so taking MDs out of the system is going to reduce wait times? only for the wealthy, for everyone else they will get longer...

I think such a notion is fully supported by some self-labelled "libertarians" who prefer the "right" (ie wealthy) people over everyone else.

[Bryan]

I'm still happy with our health care system, at least how it is run in Manitoba. I've still never seen most of the things that those who complain are claiming are commonplace.

I've never had to search more than five minutes to find a doctor, never had to wait more than a day to get an appointment, never had unreasonable waits at emergency, never had bad service, never been put on a waiting list, always get in to see specialists quickly, always get scheduled for surgery quickly, etc.

I'm just not seeing the things people are complaining about. It's not perfect, but nothing is. Sure budgets are strained, but EVERYBODY's budgets are strained these days. The only drastic change I'd like to see is better direct accounting of specifically what funds go to healthcare and how they are used. I don't like that it comes out of general revenues at the whim of the feds, even though the provinces are the ones who have to implement it.

[bloodyminded]

I'm still happy with our health care system, at least how it is run in Manitoba. I've still never seen most of the things that those who complain are claiming are commonplace.

I've never had to search more than five minutes to find a doctor, never had to wait more than a day to get an appointment, never had unreasonable waits at emergency, never had bad service, never been put on a waiting list, always get in to see specialists quickly, always get scheduled for surgery quickly, etc.

I'm just not seeing the things people are complaining about. It's not perfect, but nothing is. Sure budgets are strained, but EVERYBODY's budgets are strained these days. The only drastic change I'd like to see is better direct accounting of specifically what funds go to healthcare and how they are used. I don't like that it comes out of general revenues at the whim of the feds, even though the provinces are the ones who have to implement it.

My personal experience is similarly excellent.

And for those who would decry it (fair enough) as undemonstrable personal anecdote...that's exactly the method used to indict the system on a regular basis.

Edited December 8, 2010 by bloodyminded

[Michael Hardner]

I'm still happy with our health care system, at least how it is run in Manitoba. I've still never seen most of the things that those who complain are claiming are commonplace.

I've never had to search more than five minutes to find a doctor, never had to wait more than a day to get an appointment, never had unreasonable waits at emergency, never had bad service, never been put on a waiting list, always get in to see specialists quickly, always get scheduled for surgery quickly, etc.

I'm just not seeing the things people are complaining about. It's not perfect, but nothing is. Sure budgets are strained, but EVERYBODY's budgets are strained these days. The only drastic change I'd like to see is better direct accounting of specifically what funds go to healthcare and how they are used. I don't like that it comes out of general revenues at the whim of the feds, even though the provinces are the ones who have to implement it.

Bryan, the problem is that many people take your view of it and we need much more. The numbers don't lie, as much as the governments try to hide them.

[Evening Star]

My personal experience is similarly excellent.

(Mine too. I'm especially satisfied and impressed by my community health centre. I was guessing that maybe the situation is harder in more remote or rural areas?)

[Michael Hardner]

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

The system hasn't drastically changed since the 1960s, and costs keep increasing. Some of these increases are demographic problems (aging population) but not all.

The political system of managing services is starting to break down. What happens now is that costs increase over time, until the public wakes up and elects a cut-and-slash politician to cut things to the bone. It's not a good way to manage the system.

Edited December 8, 2010 by Michael Hardner

[wyly]

I'm still happy with our health care system, at least how it is run in Manitoba. I've still never seen most of the things that those who complain are claiming are commonplace.

quality of service can vary by region...

[wyly]

The system hasn't drastically changed since the 1960s, and costs keep increasing. Some of these increases are demographic problems (aging population) but not all.

there is also a price to pay for longer lifespan, there is more medical intervention than in the past and more improved technology/researce... every improvement in care or increase in average lifespan comes with a matching increase in cost...

The political system of managing services is starting to break down. What happens now is that costs increase over time, until the public wakes up and elects a cut-and-slash politician to cut things to the bone. It's not a good way to manage the system.

you're describing the Alberta system...blow up hospitals, sell off others,freeze wages and hiring, restrict funding for training and than act surprised when there's a backlog of healthcare service...this is what happens when you elect people who have no expertise in the issues they're mucking about in...professionals trained in running non profit medical organizations and MDs need to be running our healthcare not politically appointed lackeys...

look who Alberta has had for Health Ministers- Dave Hancock-lawyer...Ron Liepert, high school dropout/journalist...Gene Zwozdesky, degree in education...

and then we had MD Raj Sherman, president of the Emergency Physicians of Alberta within the Alberta Medical Association, who was only parliamentary assistant to the Minister of Health (the highschool dropout/journalist) until he spoke up about the ineptitude of the government on healthcare and ER response in particular and was kicked out of the government...they fired their only expert on ER care! because he said they were not listening...

[Evening Star]

This opinion piece raises the valuable point that a more economically egalitarian society might be healthier and thus less of a drain on the health-care system: http://www.theglobeandmail.com/news/opinions/opinion/to-manage-health-costs-invest-in-social-well-being/article1828960/

[Bryan]

The numbers don't lie, as much as the governments try to hide them.

You'd be hard pressed to find anything that lies more often than "the numbers".

[Michael Hardner]

professionals trained in running non profit medical organizations and MDs need to be running our healthcare not politically appointed lackeys...

MDs do run hospitals now, and that makes no sense to me. They should provide input to people who can organize services. I have worked with MDs, and even celebrated ones, and it's not the same mindset that can be focused on organization.

The system needs to be reorganized. I'm not sure where the expertise would come from, but an understanding of information management concepts would be essential.

[Michael Hardner]

You'd be hard pressed to find anything that lies more often than "the numbers".

The numbers don't lie. People lie, and use fake numbers to back up the lies.

If you can get an independent group of subject matter experts to agree on metrics, then you have a baseline from which to measure. CIHI was set up to do this, but it's been painfully slow to make progress and nobody knows who they are anyway.