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

[pinko]

See the 1988 Federal Election. That was the decisive election on the topic of freer trade. From there, we went to NAFTA and more global agreements. The two main parties actively negotiate trade agreements around the clock. If you're against that, I suggest the NDP: they seem to be the most cautious world traders.

As was pointed out - "consumers wanted it because they could have cheaper goods and services"

I actively opposed the FTA from the outset. It was a great deal for corporations and a lousy deal for many others.

[Michael Hardner]

I actively opposed the FTA from the outset. It was a great deal for corporations and a lousy deal for many others.

"Active opposition" how ? Protests ? If so, then I would consider you to have provided input through political expression.

[Molly]

Dre... #245...

Well expressed.

[wyly]

If they're exporting professionals to us, then yes they will care.

no, they don't willingly export medical professionals they come on their own, it's a net loss to their economy and their healthcare...just as we were concerned with the loss of MDs to the US, we subsidize the MD's education and then lose them to the US that's a bargain for the US, a loss for canada...S Africa has not been pleased with their MDs moving to Canada...

[wyly]

That's ridiculous. Of course we can determine that. Why don't we try ?

what's ridiculous is you want to spend millions to determine the quality of another countries MD's and medical schools, that's their problem not ours...it only becomes our concern when those MD's want to work in canada...

[Michael Hardner]

no, they don't willingly export medical professionals they come on their own, it's a net loss to their economy and their healthcare...just as we were concerned with the loss of MDs to the US, we subsidize the MD's education and then lose them to the US that's a bargain for the US, a loss for canada...S Africa has not been pleased with their MDs moving to Canada...

And yet it still happens. I'm sure that medical schools in India would be willing to participate in an audit that could validate their status as a top institution.

what's ridiculous is you want to spend millions to determine the quality of another countries MD's and medical schools, that's their problem not ours...it only becomes our concern when those MD's want to work in canada...

Spend ? No. Invest ? Yes. The end result would ostensibly be lower labour costs for the Canadian system.

Edited January 24, 2011 by Michael Hardner

[wyly]

And yet it still happens. I'm sure that medical schools in India would be willing to participate in an audit that could validate their status as a top institution.

there's nothing in it for them only a downside if they come up short...they're best graduates will still come here and find employment and their worst graduates will still have employment there...

Spend ? No. Invest ? Yes. The end result would ostensibly be lower labour costs for the Canadian system.

so you want to drive wages down, it's wages that attract the best MD's...but you want to drive wages down so our MD's will look elsewhere for employment?...

[Michael Hardner]

there's nothing in it for them only a downside if they come up short...they're best graduates will still come here and find employment and their worst graduates will still have employment there...

No, there's clearly an upside if they are indeed the best. How would certification of this sort not work in India's medical schools when it works elsewhere ?

so you want to drive wages down, it's wages that attract the best MD's...but you want to drive wages down so our MD's will look elsewhere for employment?...

You insist that we want to drive wages down, but it's costs that we're looking to control.

[bush_cheney2004]

No, there's clearly an upside if they are indeed the best. How would certification of this sort not work in India's medical schools when it works elsewhere ?

It does work...there is no evidence that Canada's medical schools do not fair exactly the same way based on world rankings....some good...others quite mediocre....just as in other nations.

[Michael Hardner]

It does work...there is no evidence that Canada's medical schools do not fair exactly the same way based on world rankings....some good...others quite mediocre....just as in other nations.

I am thinking that if we get a popular moving to bring less expensive Indian doctors here to supplement the system and help with queues ... that it would have a good effect on our current system, even if the plan doesn't go forward.

[bush_cheney2004]

I am thinking that if we get a popular moving to bring less expensive Indian doctors here to supplement the system and help with queues ... that it would have a good effect on our current system, even if the plan doesn't go forward.

I agree...especially for General Practitioners if they are so crucial as the gatekeepers to "free health care".

[The_Squid]

Robbing other nations' doctors is not a laudible goal.

We should certainly be cutting military budgets and putting that money towards health and education.

[The_Squid]

I agree...especially for General Practitioners if they are so crucial as the gatekeepers to "free health care".

No one here thinks that it is free....

The ironic part is, Canada spends less per capita than America does despite the fact that every single person in the country is covered in Canada. And administrative costs are significantly cheaper in Canada.

Our government-run healthcare is, in fact, a cheaper system than in the USA.

http://www.bloomberg.com/apps/news?pid=newsarchive&sid=a_zs1Y1FspIM

Opponents of overhauling U.S. health care argue that Canada shows what happens when government gets involved in medicine, saying the country is plagued by inferior treatment, rationing and months-long queues.

The allegations are wrong by almost every measure, according to research by the Organization for Economic Cooperation and Development and other independent studies published during the past five years. While delays do occur for non-emergency procedures, data indicate that Canada’s system of universal health coverage provides care as good as in the U.S., at a cost 47 percent less for each person.

[bush_cheney2004]

No one here thinks that it is free....

See quotation marks.

The ironic part is, Canada spends less per capita than America does despite the fact that every single person in the country is covered in Canada. And administrative costs are significantly cheaper in Canada.

That's swell...Canadians just have to do their civic duty and wait for that cheaper health care as long as it takes.....some choose to go to the "states" anyway.

Our government-run healthcare is, in fact, a cheaper system than in the USA.

It sure as hell is...and it shows.

[dre]

I am thinking that if we get a popular moving to bring less expensive Indian doctors here to supplement the system and help with queues ... that it would have a good effect on our current system, even if the plan doesn't go forward.

That was actually an early iteration of my plan... I moved onto the idea of moving the patients instead for a couple of reasons. The medical associations have a strangle-hold on the certification process and they have managed it intentionally in a way that creates an acute and chronic shortage. It will be hard to get them to certify enough doctors to bring down costs. The other reason for moving the patients whenever possible is a lot of the savings in other markets dont come just from the affordable doctors but from everything else as well (living costs, cost of purchasing land for facilities, cost of permitting, cost of contruction, and all other indirect costs, all of which are lower).

But what you suggest is a prudent step in the right direction. Back to the standards and certification process... it makes absolutely no sense to set standards so high that you have a shortage. If you only allowed the top 10% of auto mechanics to work in the industry you would be able to boast about your high standards and consistant quality but you would have to wait around for a year to get your car worked on. We need to look at some of the doctors that are failing... are they really so poorly trained that they are totally unable to play a constructive part in care delivery? In most cases I highly doubt thats the case.

[Michael Hardner]

That was actually an early iteration of my plan... I moved onto the idea of moving the patients instead for a couple of reasons. The medical associations have a strangle-hold on the certification process and they have managed it intentionally in a way that creates an acute and chronic shortage. It will be hard to get them to certify enough doctors to bring down costs. The other reason for moving the patients whenever possible is a lot of the savings in other markets dont come just from the affordable doctors but from everything else as well (living costs, cost of purchasing land for facilities, cost of permitting, cost of contruction, and all other indirect costs, all of which are lower).

Maybe... but I think a better plan would be to suggest the wholesale import of medical professionals under a special visa, for the purpose of helping the system deal with shortages. Also, propose a new organizational structure that would manage all of it and bill back to the province.

That might wake somebody up.

But what you suggest is a prudent step in the right direction. Back to the standards and certification process... it makes absolutely no sense to set standards so high that you have a shortage. If you only allowed the top 10% of auto mechanics to work in the industry you would be able to boast about your high standards and consistant quality but you would have to wait around for a year to get your car worked on. We need to look at some of the doctors that are failing... are they really so poorly trained that they are totally unable to play a constructive part in care delivery? In most cases I highly doubt thats the case.

Good point. And you could also don a cloak of false outrage whenever anyone suggested "lowering our standards".

Why don't we cut the number of doctors in half by the way ? Then our standards would be even higher.

[eyeball]

Maybe... but I think a better plan would be to suggest the wholesale import of medical professionals under a special visa, for the purpose of helping the system deal with shortages.

Who deals with the health care shortages in the countries we rob of professionals?

If we're capable of such obvious hard-nosed callousness abroad I fail to see why we're so incapable of it at home.

[wyly]

Maybe... but I think a better plan would be to suggest the wholesale import of medical professionals under a special visa, for the purpose of helping the system deal with shortages. Also, propose a new organizational structure that would manage all of it and bill back to the province.

That might wake somebody up.

right and you can be the first inline for surgery with an MD that can't qualify for a medical residency in Canada...

Good point. And you could also don a cloak of false outrage whenever anyone suggested "lowering our standards".

Why don't we cut the number of doctors in half by the way ? Then our standards would be even higher.

I hope that was sarcasm

[M.Dancer]

Who deals with the health care shortages in the countries we rob of professionals?

If we're capable of such obvious hard-nosed callousness abroad I fail to see why we're so incapable of it at home.

And what totalitarian measures would you use to stop the free movement of people? The Cabin Boy Wall?

[Bonam]

I never said anything remotely like that. Was it bad that factory and auto workers got to be part of the middle class? Why didnt workers in the manufacturing sector have the same right to government protection from competition as workers in the healthcare system? Why not the engineering sector? (I already explained why).

Of course it's not a matter of government protection for a certain profession. Rather, it is a matter of government money paying for services to be done in Canada, money to be paid to Canadians. When money is spent by the Canadian government in Canada, it stays in Canada, circulating through the economy. When money is paid by the Canadian government to India, that money is no longer in the Canadian economy. Unlike a private company whose only motivation, rightly, is profit, a government entity is expected to take into account the benefit of Canada and of Canadians. That benefit is not best served by paying other countries to do what we could be doing ourselves. Anyway, the real barrier you so protest is that of the qualification standards imposed by medical professional associations: a private group, not a government entity.

Did I miss it? Are you a protectionist? Its ok if you are, and theres merit to that viewpoint... i just wouldnt have guessed that about you.

I am not a protectionist, but I do believe that a nation should not let itself get too dependent on others for basic goods and services. It is a matter of national security to be able to provide a nation's people with food, water, shelter, energy, and yes, healthcare too. If most of our health care was done in India, naturally the capacity of our own health care system would not expand as much as if all our healthcare was done here. Thus, if our relations with India ever soured so that Canadian citizens no longer had the freedom to travel to India for health procedures and needed to have them done here, our system would be utterly incapable of handling that. Even if our relations didn't sour, Indian health policies could easily change at the discretion of the Indian government, for example once their economy develops further they could well prioritize health care for their own citizens in some kind of public system and disincentivize profit-driven health care for foreigners. Then we would have very severe problems. As a Canadian citizen, I do not want my access to health care to end up depending on the decisions of a government that I have no voice in. And that is precisely what would happen, as health care was "outsourced", our domestic capacity would dwindle.

[Jerry J. Fortin]

The health care crisis is all about costs. No resolution is possible without addressing this point. The key to resolving it is to control costs, period. The way to do that is to look at spending, mot government spending as per say, but the way people are spending government money. The place to find solutions is through controlling primary care costs and investing in prevention plans. Its complicated sure, but so is the problem itself and we simply wont solve it without cost control. It will cost thousands of dollars TO GO TO EMERGENCY, or a few dozen dollars to see a family doctor. That is not very surprising, what is surprising is that so many people go to the local emerg for colds and flu problems. These are probably the folks complaining about wait times!

WE need more doctors, and way more nurses staffing local medical centres. We need more MRI's and techs to run them. We need cheaper meds and ways to dispense them. WE need a lot of stuff, but we need to understand the nature of the problem in order to design some infrastructure to deal with it. No simple solutions will serve us.

[dre]

Of course it's not a matter of government protection for a certain profession. Rather, it is a matter of government money paying for services to be done in Canada, money to be paid to Canadians. When money is spent by the Canadian government in Canada, it stays in Canada, circulating through the economy. When money is paid by the Canadian government to India, that money is no longer in the Canadian economy. Unlike a private company whose only motivation, rightly, is profit, a government entity is expected to take into account the benefit of Canada and of Canadians. That benefit is not best served by paying other countries to do what we could be doing ourselves. Anyway, the real barrier you so protest is that of the qualification standards imposed by medical professional associations: a private group, not a government entity.

I am not a protectionist, but I do believe that a nation should not let itself get too dependent on others for basic goods and services. It is a matter of national security to be able to provide a nation's people with food, water, shelter, energy, and yes, healthcare too. If most of our health care was done in India, naturally the capacity of our own health care system would not expand as much as if all our healthcare was done here. Thus, if our relations with India ever soured so that Canadian citizens no longer had the freedom to travel to India for health procedures and needed to have them done here, our system would be utterly incapable of handling that. Even if our relations didn't sour, Indian health policies could easily change at the discretion of the Indian government, for example once their economy develops further they could well prioritize health care for their own citizens in some kind of public system and disincentivize profit-driven health care for foreigners. Then we would have very severe problems. As a Canadian citizen, I do not want my access to health care to end up depending on the decisions of a government that I have no voice in. And that is precisely what would happen, as health care was "outsourced", our domestic capacity would dwindle.

"Most of our healthcare" will never be done in India. At the very most about 15% to 25% would even be possible to offshore. The canadian healthcare industry is not keeping up with demand, and we cant afford to have cost keep increasing 5%-10% like it is in the US. Making sure we have affordable healthcare is way more important than any of your other concerns so offshoring procedures when its economically viable makes good sense. Everybody wins.

[Bonam]

"Most of our healthcare" will never be done in India. At the very most about 15% to 25% would even be possible to offshore.

Indeed? And you arrived at these numbers based on extensive research and rigorous analysis on this subject I'm sure? Anyway, if only a few % of health care gets offshored, it will hardly make a dent in perpetually growing health care budgets, that kind of defeats your own argument.

Making sure we have affordable healthcare is way more important than any of your other concerns so offshoring procedures when its economically viable makes good sense. Everybody wins.

By "making sure we have affordable healthcare" you really mean making sure India has lots of health care that it is willing to sell to Canadians for now, while our own system is neglected. Also, why is it that you get to decide which concerns are "more important". I don't recall electing you president.

Edited January 25, 2011 by Bonam

[dre]

Indeed? And you arrived at these numbers based on extensive research and rigorous analysis on this subject I'm sure? Anyway, if only a few % of health care gets offshored, it will hardly make a dent in perpetually growing health care budgets, that kind of defeats your own argument.

By "making sure we have affordable healthcare" you really mean making sure India has lots of health care that it is willing to sell to Canadians for now, while our own system is neglected. Also, why is it that you get to decide which concerns are "more important". I don't recall electing you president.

Some analysis and research, and some common sense. Some emergency patients cant fly. Emergency care has to be done where the emergencies are, and people will still need to see general practitioners. It WILL make a dent though because the saving on operations you can offshore are so huge.

The only other option is to ration care more, or raise taxes.

By "making sure we have affordable healthcare" you really mean making sure India has lots of health care that it is willing to sell to Canadians for now, while our own system is neglected.

No our system will just change like other industries did. We will still do emergency care, and some of the diagnostic work, and management work. Just like with other industries the portions that get offshored will be the ones where it makes sense economically. Its idiotic for health canada to buy a service for 200 thousand dollars that it can get for 15 thousand somewhere else... a government that makes decisions like that will not be solvent for long, and the huge tax hikes that will be required to provide universal care in the current protectionist system will damange the rest of the economy as well.

Edited January 25, 2011 by dre

[eyeball]

And what totalitarian measures would you use to stop the free movement of people?

None whatsoever. If I was in charge, our border would be every bit as open and inviting for the patients these doctors left behind as it is for their doctors.