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

[Moonlight Graham]

By health care crisis, i of course refer to the fact that baby boomers are getting older and soon this large age group they will be jamming up the already-stressed public health-care system.

Of the top of my head, i can think of 3 ways this can be dealt with:

1) Raise taxes

2) deficit spending and racking up the debt for a few more decades.

3) introduce substantial 2-tier healthcare

I'm wondering what you think is most likely to occur? Or is there another obvious solution i missed?

Personally i think it may be a combination of all 3. Though i would think #2 would be most likely. 2-tier will only happen if higher taxes and/or debt can't solve the problems.

[pinko]

I challenge the premise of the question. While there is no doubt an aging population brings with it some issues of care those may be mitigated to some extent with a model that stresses positive lifestyle changes for those of all ages. Secondly a reallocation of human resources within the medical field is essential and this, in conjunction with technological change, should bring about more control on the expenditure side of the equation.

It should be noted that government policy in the 90s resulted in decreased enrollment in the medical field specifically as it related to doctors and nurses.

Edited January 18, 2011 by pinko

[Smallc]

Since the 3rd one doesn't actually solve anything, it had better be one of the first two.

Edited January 18, 2011 by Smallc

[Keepitsimple]

Wouldn't it be nice if we could just keep going the way we are going....."free" Healthcare. In fact though, as costs keep going up, we've been "rationing" services.....long line-ups, incredible wait times to see specialists, very hard to find a family doctor. So.....I can see the Provinces being forced to:

1) Charge User Fees....the trick is how do you exempt the poor.

2) Provide an annual invoice of services so people can see how much they are costing Medicare and they can see that it's not "free". This would also help to flush out any fraud in the system - and discourage it.

3) In lieu of charging a User Fee with each visit, the introduction of the Annual Invoice of Services could allow a single User Surcharge to be paid at tax time. This would help address the issue of the poor as they would pay nothing or a proportion of the fees depending on income.

4) Allow Nurse Practioners to provide more services

5) Continue speeding up the acreditation of foreign doctors as General Practitioners. Go to any ER - especially in winter - and you will see a huge number of cases that should have been handled by the family doctor.....but it's hard to get in to see one - so people go to Emergency.

6) Allow private delivery of services under the public umbrella for specific practices as is being done on a limited basis today. Hip and knee relacements, MRI's, Arthroscopic procedures. No queue jumping, no private payments....just a fee for service from Medicare to the private supplier. Doing one thing - and doing it well can speed things up and take pressure off of hospitals.

A critical point in the Healthcare discussion is to stop abusing the term Two Tier Healthcare - that's US style medicine which very few in Canada advocate. Productive discussions in Canada have revolved around private delivery mechanisms delivered through the public system with equal access for all. Two Tier Healthcare is a bogeyman word used by those who prefer the status quo, ignore the reality of unsustainability, and simply wring their hands and expect more money to solve the "problem".

Edited January 18, 2011 by Keepitsimple

[bloodyminded]

A critical point in the Healthcare discussion is to stop abusing the term Two Tier Healthcare - that's US style medicine which very few in Canada advocate. Productive discussions in Canada have revolved around private delivery mechanisms delivered through the public system with equal access for all. Two Tier Healthcare is a bogeyman word used by those who prefer the status quo, ignore the reality of unsustainability, and simply wring their hands and expect more money to solve the "problem".

I'm not quite seeing a problem with this idea, though perhaps someone could educate me. The government already buys health care products--all of them--from private companies. The government doesn't stitch smocks, build rotating upper gi tables or stethoscopes. How would private delivery mechanisms be philosophically or practically different?

[bush_cheney2004]

.... How would private delivery mechanisms be philosophically or practically different?

They could be delivered faster with more supply....natch.

[Michael Hardner]

In order to assess any problem, you need information. We the public do not have adequate information on healthcare. Information is saved locally and not distributed. Management is heavily centralized into islands that report ultimately to political bodies, but in fact there's enough complexity so that even this doesn't really happen.

I'm not convinced that boomers are the issue, for example, because health care costs have risen almost as much in countries without a boom.

The system needs to be made open, accountable, decentralized, and people have to care and pay attention.

[bloodyminded]

They could be delivered faster with more supply....natch.

And if this is so, then like I said, I see no reason not to use them. If someone has a good rebuttal, I'll listen.

[pinko]

They could be delivered faster with more supply....natch.

Do you have any proof of this?

[bush_cheney2004]

Do you have any proof of this?

Yes...standing provincial contracts with American hospitals and clinics (e.g. neonatal care).

[Keepitsimple]

I'm not quite seeing a problem with this idea, though perhaps someone could educate me. The government already buys health care products--all of them--from private companies. The government doesn't stitch smocks, build rotating upper gi tables or stethoscopes. How would private delivery mechanisms be philosophically or practically different?

There is no difference - unless private facilitators who do surgeries for example, allow people to "pay their way" to the front of the line instead of providing equal access for all.

Edited January 18, 2011 by Keepitsimple

[bloodyminded]

There is no difference - unless private facilitators who do surgeries for example, allow people to "pay their way" to the front of the line instead of providing equal access for all.

Oh yes, of course. I'm certainly all for keeping up core principles of universal health care.

But (and we agree) that doesn't demand that private entities are kept out entirely. They never were...and couldn't be. They just can't have any decision-making power over patients, access, and so on.

[Saipan]

There's no health care crisis.

Those who eat junk, drink too much, smoke and never exercise will soon die.

Charles Darwin said so.

[pinko]

Yes...standing provincial contracts with American hospitals and clinics (e.g. neonatal care).

Produce them. My son is a doctor and has worked in both the Canadian and American systems. While he certainly sees the need for improvement in the Canadian system he has indicated the American model is burdened with bureacratic structures created by the insurance companies and HMOs.

[Shady]

We need to introduce privately run clinics and/or hospitals. We need to legalize the ability to use your own money to pay for health care, if one chooses to do so. We have the government option. We now need a private option as well. Let people spend their own money for the love of God!!!!

[eyeball]

A few posters have pointed to lifestyle and junk food as factors to consider in healthcare. The first could continue to be addressed through public education, improve it if need be but basically keep on stressing and reinforcing the need to keep fit, not just for your own sake but also for the sake of our over-stressed health-care system. By the very same token I'm all for more government regulation of what producers are allowed to put into food given so much poor health can be attributed to what people eat. It's just such an obvious point at which a source of such ill health can be choked off before it can cause problems, I think we should avail ourselves the opportunity to do so.

As for people who drink and smoke or consume other substances to excess, tax them and apply every penny to health care.

[Shady]

A few posters have pointed to lifestyle and junk food as factors to consider in healthcare. The first could continue to be addressed through public education, improve it if need be but basically keep on stressing and reinforcing the need to keep fit, not just for your own sake but also for the sake of our over-stressed health-care system. By the very same token I'm all for more government regulation of what producers are allowed to put into food given so much poor health can be attributed to what people eat. It's just such an obvious point at which a source of such ill health can be choked off before it can cause problems, I think we should avail ourselves the opportunity to do so.

As for people who drink and smoke or consume other substances to excess, tax them and apply every penny to health care.

Alcohol and cigarettes are already highly taxed. It's not as if that idea hasn't been thought of and alreday implemented.

Lifestyle and junk food have little to do with it. People are living much longer, and in the case of baby boomers, there's more of them. Those are the issues that need to be addressed. Not food, alcohol, and cigarettes.

[pinko]

We need to introduce privately run clinics and/or hospitals. We need to legalize the ability to use your own money to pay for health care, if one chooses to do so. We have the government option. We now need a private option as well. Let people spend their own money for the love of God!!!!

Maybe you should head south if you want to spend your money.

[Shady]

Maybe you should head south if you want to spend your money.

I want to spend my money here. At least I want the option.

[bloodyminded]

There's no health care crisis.

Those who eat junk, drink too much, smoke and never exercise will soon die.

Charles Darwin said so.

No he didn't.

[pinko]

I want to spend my money here. At least I want the option.

You have the option. There are a variety of healthcare services already in the private sphere here in Canada for you to purchase.

[Saipan]

No he didn't.

You heard him not saying that?

[Shady]

You have the option. There are a variety of healthcare services already in the private sphere here in Canada for you to purchase.

I don't want the government dictating what health care I can, and cannot spend my own money on.

[bloodyminded]

You heard him not saying that?

Ok, let's bet our total income for ten years: I say Darwin didn't say what you claimed; you say he did say it.

Now, the only reasonable way to settle the dispute--and it should be easy for you--is to provide the Darwin reference in which he did say it. (I can't easily prove he didn't--even though of course we all know he didn't--without simply pasting all his text here. So you should provide the evidence, and then we'll know!)

[Michael Hardner]

And, as usual, nobody seems to care that we don't have good information about the problem and many are ready to offer solutions...