Your predictions on how we will deal with the coming health care crisi

[Michael Hardner]

August1991, I'm not an expert but what you describe just does not sound like the health care system I'm familiar with. Nor does it sound similar to anything else I've read by informed people.

These "informed people" are the experts that you trust to tell you everything is ok then ? Do you do this with other services that you receive ?

If you read an article saying that your phone/cable company was responsive and customer focused would you believe that too ? No.

Those companies have an oligopoly, in that they only have to be better than a few other companies to do well. And the service is terrible. With monopolies, it's usually worse. How do we deal with it ? Some of us read articles from informed people that tell us everything is good.

Others read performance reports like the Ontario Wait Times report and notice that all is not well.

[pfezziwig]

Federal politicans from around the world have shown no ability to stop spending in an unsustainable manner. The only time this changes is when they achieve bankruptcy and have no choice but to alter their spending habits. At that point they will allow the private sector in to operate freely in canada and their will be a two tier system for rich and poor.

Canada is following the same path as several other countries, our oil resources are just prolonging this point, give us another 10 years and we will 'achieve' the state Greece, Ireland, Italy and California are in (we'll have lots more company in 10 years too).

If they just allowed the private sector in now we would have a much better public healthcare system in 10 years time, guess people need to learn the hard way, there's no way any politican can propose this nowadays.

[pinko]

Federal politicans from around the world have shown no ability to stop spending in an unsustainable manner. The only time this changes is when they achieve bankruptcy and have no choice but to alter their spending habits. At that point they will allow the private sector in to operate freely in canada and their will be a two tier system for rich and poor.

Canada is following the same path as several other countries, our oil resources are just prolonging this point, give us another 10 years and we will 'achieve' the state Greece, Ireland, Italy and California are in (we'll have lots more company in 10 years too).

If they just allowed the private sector in now we would have a much better public healthcare system in 10 years time, guess people need to learn the hard way, there's no way any politican can propose this nowadays.

More unfounded comment with not an iota of proof.

[Michael Hardner]

More unfounded comment with not an iota of proof.

The thing is, costs are rising... and the only think being realistically discussed right now is a private option. So where do you think we're going to go ?

If someone (with power) can offer a real alternative to "trust the experts" then that would probably go a long way.

Edited January 21, 2011 by Michael Hardner

[pinko]

The thing is, costs are rising... and the only think being realistically discussed right now is a private option. So where do you think we're going to go ?

If someone (with power) can offer a real alternative to "trust the experts" then that would probably go a long way.

The problem with the position you stake out is that you present no tangible evidence that the private option you refer to will result in savings. Why should I place trust in a proposition lacking proper analysis?

[Evening Star]

These "informed people" are the experts that you trust to tell you everything is ok then ? Do you do this with other services that you receive ?

If you read an article saying that your phone/cable company was responsive and customer focused would you believe that too ? No.

Those companies have an oligopoly, in that they only have to be better than a few other companies to do well. And the service is terrible. With monopolies, it's usually worse. How do we deal with it ? Some of us read articles from informed people that tell us everything is good.

Others read performance reports like the Ontario Wait Times report and notice that all is not well.

OK, Michael, but I also haven't seen the rigourous evidence to support August1991's position that Canada's health care system "revolves entirely" around scenarios of nepotism and corruption, certainly not from him. I didn't say everything is OK, just that I don't agree that the system is what he describes it to be.

[Michael Hardner]

The problem with the position you stake out is that you present no tangible evidence that the private option you refer to will result in savings. Why should I place trust in a proposition lacking proper analysis?

You entirely missed my point. I'm not staking out a position pro/against privatization. I'm saying it's the only new option being realistically discussed right now.

[Michael Hardner]

OK, Michael, but I also haven't seen the rigourous evidence to support August1991's position that Canada's health care system "revolves entirely" around scenarios of nepotism and corruption, certainly not from him. I didn't say everything is OK, just that I don't agree that the system is what he describes it to be.

I highly recommend you start talking about what is wrong with the system, and exploring alternatives for change other than privatization. The thing is, that is the only option discussed today. As such, the (implicit) position that the system is fine as it is stands as defending the status quo.

As time goes on, the system continues to cost more and service is more at odds with the public's experiences in other areas of life. If that continues, then the status quo will yield to a two-tiered system, since that's the only alternative out there.

[PIK]

...pssst, Police budget is the city's problem, Health is a Prov/Fed problem.

I know but no matter what ,it is our money. I deal with public housing and the people that have to enter the apts for mainetance,can tell you stories that makes you want to puke. Not only that they are 1/2 full of able bodied young people on welfare and the destruction and stinking mess these people leave behind or just live in. There is no excuse to live like a pig no matter how much money you have. The skids of toilets alone that they go thru and the amount of drywall and mud that they go thru. These people that deal with it need a huge raise for what they have to endour in their jobs. We throw so much money away and never really look to see if it being spent properly, that if we did we could have what we want in services without breaking the bank. I remmeber the fuss made over mike harris work share program, that is what we need now, even if it is helping out with snow removing or keeping parks and roads clean of litter in warmer months. We brought in 260000 foreign workers into the country last year which cost us alot in the end. Edited January 21, 2011 by PIK

[bush_cheney2004]

I highly recommend you start talking about what is wrong with the system, and exploring alternatives for change other than privatization. The thing is, that is the only option discussed today. As such, the (implicit) position that the system is fine as it is stands as defending the status quo.

Other ideas are squelched because of politics. There has been no shortage of the obvious answers like co-pays for each visit and reducing coverage for expensive procedures. Here is a CBC op-ed piece from last year that explains the obvious:

http://www.cbc.ca/canada/story/2010/04/22/f-vp-newman.html

As time goes on, the system continues to cost more and service is more at odds with the public's experiences in other areas of life. If that continues, then the status quo will yield to a two-tiered system, since that's the only alternative out there.

As it should...."free" government dollars will continue to inflate the status quo until somebody turns off the spigot.

[wyly]

I highly recommend you start talking about what is wrong with the system, and exploring alternatives for change other than privatization. The thing is, that is the only option discussed today. As such, the (implicit) position that the system is fine as it is stands as defending the status quo.

As time goes on, the system continues to cost more and service is more at odds with the public's experiences in other areas of life. If that continues, then the status quo will yield to a two-tiered system, since that's the only alternative out there.

you haven't identified why it costs more or even if it actually does...have increases accounted for normal inflation...growing population...increased cost of living in each region or city...that there are increasingly higher demands on the system due to the boomer generation...increasingly longer life spans causing canadians to make more use of the system...that new research and treatments for illnesses that there were previously thought untreatable now require a funding...

as the population ages and technology/research improves it shouldn't come as a surprise that costs are going up, in the big picture a normal event...I'm not saying the system is perfect and can't be improved but we need to be realistic about the number one priority in life, our health... there is no dollar limit anyone of us would put on the value of our lives, without good health everything else becomes irrelevant...

[bush_cheney2004]

... there is no dollar limit anyone of us would put on the value of our lives, without good health everything else becomes irrelevant...

Oh yes there is! If you think otherwise, then please pay the difference out of your own pocket or insurance policy.

[pinko]

You entirely missed my point. I'm not staking out a position pro/against privatization. I'm saying it's the only new option being realistically discussed right now.

Why limit the options? I take the position that, whereever possible, best practices be adopted. If you want to discuss the issue in that context then maybe some headway will be made.

[Michael Hardner]

you haven't identified why it costs more or even if it actually does...

I don't think anybody is disputing that costs have risen.

I haven't sufficiently identified why, nor has anybody else - especially those giving the services.

have increases accounted for normal inflation...growing population...increased cost of living in each region or city...that there are increasingly higher demands on the system due to the boomer generation...increasingly longer life spans causing canadians to make more use of the system...that new research and treatments for illnesses that there were previously thought untreatable now require a funding...

Could be...

as the population ages and technology/research improves it shouldn't come as a surprise that costs are going up, in the big picture a normal event...I'm not saying the system is perfect and can't be improved but we need to be realistic about the number one priority in life, our health... there is no dollar limit anyone of us would put on the value of our lives, without good health everything else becomes irrelevant...

Ok, so you agree costs are going up... "the system isn't perfect"... a defacto defense of the status quo...

You prove my point. What are you doing, as a citizen and healthcare consumer, to ensure that the system *improves* ? Not just stays the same, but improves ?

[Michael Hardner]

Why limit the options? I take the position that, whereever possible, best practices be adopted. If you want to discuss the issue in that context then maybe some headway will be made.

I'm not limiting the options... those who provide a defacto defense of the status quo do that, IMO.

I think a good practice would be for wait times to decrease over time... and for an identified independent party measure that and provide the information back to consumers. I also think costs for a defined set services should go down over time, all things being equal.

If costs go up, then a clear breakdown of what is happening, measured against a plan should be provided.

This should be provided via easy access (say, the web, or a paper version mailed out to those who prefer) and should be accurate and easy to read.

[wyly]

I don't think anybody is disputing that costs have risen.

I haven't sufficiently identified why, nor has anybody else - especially those giving the services.

but research, technology, growth and inflation makes it impossible for costs to remain the same...a car built in 1910 is not the technological equal of a one built in 2010 would you expect to pay the same price today for a car as in 1910?...costs increases are a normal part of life, what needs to be identified are wasteful practices not normal increases...

Ok, so you agree costs are going up... "the system isn't perfect"... a defacto defense of the status quo...

it's not a defense it's properly identifying all the factors...the final tally doesn't accurately depict the entire story...for the per capita dollar figure canadians put into healthcare we are very competitive globally, we have good health and long life spans other than a more efficient service what more can we ask for?...we whine and complain a lot but we do have an excellent stand of health care despite any problems the system may have ...

You prove my point. What are you doing, as a citizen and healthcare consumer, to ensure that the system *improves* ? Not just stays the same, but improves ?

well first off I'm discussing it here with you that's a starting point for all change in society, educating each other and coming to an informed consensus...second the electoral process, one can only cast an vote for whoever offers a solution that you believe will work...

[pinko]

Michael:

You state:

"I think a good practice would be for wait times to decrease over time..."

That is a fine goal. Now tell me what steps need to be taken to achieve that goal. Please don't reiterate the private sector option.

You further state:

"and for an identified independent party measure that and provide the information back to consumers."

Which independent party are you referring to?

Finally you state:

"I also think costs for a defined set services should go down over time"

What is the set of services you refer to?

[madmax]

Cheapest/Most affordable delivery of Health Care comes from the Public Sector.

The Most Expensives Delivery of Health Care is the Private Model.

The Most effective and fair system of health care is Universal single payer.

THe Most ineffective and beaucratic and litigous is Private Sector/Private insurance driven system.

Therefore, if you can't afford to pay for the most affordable healthcare available or it cannot sustain the current burden, you must either reduce the service to what can be delivered and payed for, or you must let those who have the ability to pay more into our health care pay for the benefit of those based on need not greed or line jumping.

All other options are folly driven by private sector lobbiests trying to get at the taxpayers trough.

At the end of the day we get less and pay more.

Others who say they can pay "more" for health care, but then say, they can't pay more to Healthcare are hypocrits.

As I see it now, people can't seem to handle payments to AutoInsurance premiums, Home Insurance, etc, and they bitch and complain especially when seeing that "Competition" in the insurance industry is a myth, these people will be in no position to pay for "private health" insurance.

And companies have no interest in coughing up monies in benefit plans any longer either. Those days are long gone.

[Michael Hardner]

but research, technology, growth and inflation makes it impossible for costs to remain the same...a car built in 1910 is not the technological equal of a one built in 2010 would you expect to pay the same price today for a car as in 1910?...costs increases are a normal part of life, what needs to be identified are wasteful practices not normal increases...

Tracking these things will answer many questions.... costs of certain things go down over time... if we didn't increase services, but only offered the same thing at the improved costs that efficiency and productivity give us then costs would go down.

it's not a defense it's properly identifying all the factors...the final tally doesn't accurately depict the entire story...for the per capita dollar figure canadians put into healthcare we are very competitive globally, we have good health and long life spans other than a more efficient service what more can we ask for?...we whine and complain a lot but we do have an excellent stand of health care despite any problems the system may have ...

We don't know what we can ask for because we don't know what we have. If we whine and complain a lot, I don't hear that. I just hear private vs public fighting.

well first off I'm discussing it here with you that's a starting point for all change in society, educating each other and coming to an informed consensus...second the electoral process, one can only cast an vote for whoever offers a solution that you believe will work...

That is a good start - next go to cihi.ca and tell me if you find anything good.

[Michael Hardner]

Michael:

You state:

"I think a good practice would be for wait times to decrease over time..."

That is a fine goal. Now tell me what steps need to be taken to achieve that goal. Please don't reiterate the private sector option.

1. Monitor the queue status in the ways I have illustrated and benchmark it. Make people pay attention.

You further state:

"and for an identified independent party measure that and provide the information back to consumers."

Which independent party are you referring to?

CIHI.ca will do for now. An auditing firm, such as an accounting firm would also do.

Finally you state:

"I also think costs for a defined set services should go down over time"

What is the set of services you refer to?

Any set of services should generally decrease in cost over time, as productivity increases and innovation work their magic.

[pinko]

1. Monitor the queue status in the ways I have illustrated and benchmark it.

What queue status? What is the benchmark and how was it arrived at?

Edited January 21, 2011 by pinko

[pinko]

"Any set of services should generally decrease in cost over time, as productivity increases and innovation work their magic."

Do you have some examples to prove your point? If so provide them.

[pinko]

B_C, the way our provincial governments deal with excess demand is through "wait times". That is, rationing.

B_C, they don't pay for Canadians to go to the US for treatment except in extreme circumstances. Instead, they make Canadians wait. This waiting cost is borne privately by Canadians and yet shows up in no government budget or even in reported health cost statistics.

For older people, or people with contacts, this cost is lower. They can avoid the queue or tolerate it. For younger people, or people outside the "system", it is a nightmare.

Pinko strikes me as a classic example. Apparently, his son is a doctor so he has easy access to the medical system. (When a friend recently asked whether he shoudl marry a particular woman, I said that it was a good idea because she worked as a hospital administrator.)

Canada's health system is Soviet and it engenders an "I'm alright, Jack" mentality. It's also foolishly wasteful as people do all kinds of crazy things to obtain a coveted slot on a waiting list.

Geyser, in my initial response to the OP, I linked to a CBC article based on Statscan study that some 4 million Canadians do not have a family doctor.

If you have a family doctor, then "you're alright". But if you don't have one, what do you do?

This is the tip of the iceberg.

I take it the Geyser comment is directed at me. I notice you have avoided describing your background, if any , in the healthcare field. I am well aware of information like that contained in the CBC article you have highlighted. I am inclined to focus more broadly on the issues at hand over an extended period of time rather than cherry pick like you have. There is nothing earth shattering in that article.

Are you one of those 4 million people without a family doctor?

Edited January 21, 2011 by pinko

[dre]

here you go again with this JCI poo again...there is guarantee to the quality of the physician you will get in foreign countries, not even in the usa...

you cannot expect canadian hospitals, MD, nurses and support staff to compete with India or Thailand and their cost of living differences, it a ludicrous idea...

and millions of Canadians are not fleeing the country for medical care...

here you go again with this JCI poo again...there is guarantee to the quality of the physician you will get in foreign countries, not even in the usa...

You dont have a clue what youre talking about. You absolutely CAN inspect and accredit foreign facilities and make sure they produce comparable patient outcomes. Its already been done. You call it poo, but millions of people from the west are already getting work done in these facilities. Futhermore my plan is voluntary anyways... if you dont trust foreign facilities then you dont have to volunteer.

you cannot expect canadian hospitals, MD, nurses and support staff to compete with India or Thailand and their cost of living differences, it a ludicrous idea...

If you dont... prices will continue to increase by between 5 and 10% a year until we have a full blown crisis. End of story. Forcing domestic providers to compete with foreign providers has been done in almost every other industry, and in every single case it has resulted in huge downward pressure on prices. If your shoes had to be made in Canada they would cost 300 bux a pair. If your consumer electronics had to be made in Canada, a dvd player would cost 300 dollars instead of $25.

If you choose to continue medical protectionism you are choosing a crisis. Period.

and millions of Canadians are not fleeing the country for medical care...

No its mostly Americans right now, but once the Canada Health Act allows for it, many Canadians will respond to the cash incentive I described. You can have your operation done in Canada, or you can have it in India and get a new car for free. Right now most Canadian medical tourists are either going for dental work, or theyre affluent people trying to get around waiting lists. But thats only because the Canadian Health Act wont pay for the procedures, which is idiocy, and has to change.

[pinko]

" Right now most Canadian medical tourists are either going for dental work, or theyre affluent people trying to get around waiting lists."

These medical tourists you refer to aren't very bright if they are going to India for dental work. While it is the case dental work isn't covered for most Canadians I have my dental work done through my Blue Cross insurance and it is always done expeditiously.