Healthcare talks

[Smallc]

I've never yet seen evidence that the formula will vary by province.  As far as I understand, it's based on Canada's overall nominal GDP growth.

[Omni]

28 minutes ago, Smallc said:

I've never yet seen evidence that the formula will vary by province.  As far as I understand, it's based on Canada's overall nominal GDP growth.

Well what is important is that they do get a new formula worked out before next year. Healthcare is important.

[drummindiver]

9 hours ago, Omni said:

The previous conservative government simply chose to cut back on transfers to healthcare. That's tough on an ageing population. At least the current federal government doesn't mind to sit down with the premiers, unlike Harper. It may take more meetings than one. 

Not true as has been pointed out ad nauseum.

8 hours ago, Smallc said:

Actually, his proposal was a firm 3.5% (the current is a minimum of 3% that can go up more with nominal GDP growth of about 3%).  Harper in fact extended the 6% increases for 2 (or was it 3?) more years.  No one decreased the transfers, and saying so is completely dishonest.

 

8 hours ago, Omni said:

Reducing the increase is a cut. 

It is still an increase. Again.

8 hours ago, Bryan said:

What Chretien did prior to Martin's deal, now THAT was a cut. The provinces actually got less than they were previously getting.

Exactly.

Martin also cut deeply into federal transfers to the provinces, which fell by 1.9 percentage points of GDP, 1992 to 2000. Most of the burden fell on social programs under provincial jurisdiction, notably public health insurance (which covers physician and hospital care) and welfare or social assistance which provides basic income support. The old formula under which the federal government paid one half of welfare costs was scrapped, and welfare rates were slashed in real terms in almost every province. Because of cuts to unemployment insurance and welfare, poverty rates remained at near recession levels through most of the 1990s, and the incomes of the bottom half of households rose very modestly, despite falling unemployment. - See more at: https://www.policyalternatives.ca/publications/monitor/beware-canadian-austerity-model#sthash.FjAiXVoa.dpuf

[Omni]

2 hours ago, drummindiver said:

Not true as has been pointed out ad nauseum.

I'll be happy to explain basic math to you some time, but for now just try to understand that when you cut an increase in half, that is a decrease.

[Smallc]

No, it's not a decrease.  It's a decrease in the increase.  Nothing more nothing less. 

[Omni]

2 minutes ago, Smallc said:

No, it's not a decrease.  It's a decrease in the increase.  Nothing more nothing less. 

Well, we're getting there.

[Smallc]

An decrease in the increase is not a decrease though. 

[Omni]

5 minutes ago, Smallc said:

An decrease in the increase is not a decrease though. 

Read your own post, especially the beginning.

[Smallc]

I can read my own post just fine.  Bryan explained it perfectly already anyway.

[?Impact]

I think what is missing here is division of financial obligation for health care. The 6% escalator clause was really about the federal government trying to restore its level of commitment (over time) to health care after things were slashed in the 90's. The real question is has that level been restored, and what will it take to maintain it? Costs rise over time due to inflation, and that include both kinds of inflation: buying power of the dollar, and increase in population. If the federal government does not cover both of those through increases then in effect it is a cut, a 0% increase is not the steady state (unless we have true 0% inflation and zero population growth). 

[Smallc]

I think there was a reason that the escalator was only designed to run for 10 years (it ended up being 12-13).  I don't think Paul Martin intended it to go on forever.

[Omni]

8 minutes ago, ?Impact said:

I think what is missing here is division of financial obligation for health care. The 6% escalator clause was really about the federal government trying to restore its level of commitment (over time) to health care after things were slashed in the 90's. The real question is has that level been restored, and what will it take to maintain it? Costs rise over time due to inflation, and that include both kinds of inflation: buying power of the dollar, and increase in population. If the federal government does not cover both of those through increases then in effect it is a cut, a 0% increase is not the steady state (unless we have true 0% inflation and zero population growth). 

And even if we maintained a zero population growth a high percentage of those already here are old and getting older, so the cut will be detrimental to their needs.

[Argus]

12 hours ago, Omni said:

The previous conservative government simply chose to cut back on transfers to healthcare. That's tough on an ageing population. At least the current federal government doesn't mind to sit down with the premiers, unlike Harper. It may take more meetings than one. 

I was not a fan of the previous government's lack of vision with regard to health care, and said so at the time. I am similarly unimpressed with Mister "I feel your pain" who consults constantly but does nothing. We need vision and courage to reform the system. We will not get it from Trudeau.

[Smallc]

That vision has to come from the provinces - this is their ball game.

[Argus]

12 hours ago, Omni said:

Healthcare payments will carry on, but they could go as low as 3% from the previously guaranteed 6%. That's quite obviously a cut. Perhaps the 6% across the board wasn't the correct approach, but the math speaks for itself.

What speaks for itself is your dishonesty. There is no cut, but the question is largely irrelevant. Even if they agreed to increase it by ten percent a year it would make little difference. Health care costs are rising beyond the ability of the provinces and federal government to pay for them. The system itself needs a drastic overhaul which needs to include user fees and privately supplied resources similar to what exists in Europe.

 

[Argus]

3 minutes ago, Smallc said:

That vision has to come from the provinces - this is their ball game.

They are governed by the federal health act. That is what needs to change.

[Omni]

4 minutes ago, Argus said:

What speaks for itself is your dishonesty. There is no cut, but the question is largely irrelevant. Even if they agreed to increase it by ten percent a year it would make little difference. Health care costs are rising beyond the ability of the provinces and federal government to pay for them. The system itself needs a drastic overhaul which needs to include user fees and privately supplied resources similar to what exists in Europe.

 

And where is the so called dishonesty?

[Argus]

3 minutes ago, Omni said:

And where is the so called dishonesty?

I'm not getting into you clown show discussion of trying to pretend a smaller increase is a cut.

Edited December 20, 2016 by Argus

[Omni]

1 minute ago, Argus said:

I'm not getting into you clown show discussion of trying to pretend a smaller increase is a cut.

I guess if I cut your allowance in half you'd get it.

[Argus]

Just now, Omni said:

I guess if I cut your allowance in half you'd get it.

That would be a cut to my existing allowance, which is not what the government is doing.

[Smallc]

14 minutes ago, Argus said:

They are governed by the federal health act. That is what needs to change.

There's nothing wrong with that act in my opinion.  People should all be provided with the same medically necessary services.  We need to find better and less expensive ways to do that.  The problems with this file will always be our geography, and our proximity to the US.  Those things inflate costs, especially salaries.

[Omni]

2 minutes ago, Argus said:

That would be a cut to my existing allowance, which is not what the government is doing.

Well hopefully they get back to the table and not let that happen. I do tend to agree with the feds that it shouldn't only focus on dollars but also on finding efficiencys.

[Argus]

1 minute ago, Smallc said:

There's nothing wrong with that act in my opinion.  People should all be provided with the same medically necessary services.  We need to find better and less expensive ways to do that.  The problems with this file will always be our geography, and our proximity to the US.  Those things inflate costs, especially salaries.

The Europeans do things a lot smarter, and user fees help discourage that small group of hypochondriacs responsible for a vastly disproportionate share of expenses. Waiting weeks for an appointment with your GP or months to get an appointment with a specialist is unacceptable. 

[Smallc]

15 minutes ago, Argus said:

The Europeans do things a lot smarter, and user fees help discourage that small group of hypochondriacs responsible for a vastly disproportionate share of expenses. Waiting weeks for an appointment with your GP or months to get an appointment with a specialist is unacceptable. 

I agree with that, which is why I said we need to do things smarter.  I'm not opposed to user fees either, but you and I both know that people on social assistance and low income programs (that's not necessarily and indictment of them, but a realty - I realize there are a multitude of reasons why things are thus) who overuse the system now won't have to pay any, and will still overuse the system.

It also doesn't help the problems of geography or the American system and its upward pressure on wages, something we'll always have.

Edited December 20, 2016 by Smallc

[Argus]

5 minutes ago, Smallc said:

I agree with that, which is why I said we need to do things smarter.  I'm not opposed to user fees either, but you and I both know that people on social assistance and low income programs (that's not necessarily and indictment of them, but a realty - I realize there are a multitude of reasons why things are thus) who overuse the system now won't have to pay any, and will still overuse the system.

It also doesn't help the problems of geography or the American system and its upward pressure on wages, something we'll always have.

I reject the notion of geography to begin with. I've seen no evidence it costs more here because of geography, nor evidence very small geographical areas like Switzerland, say, pay less because of that. But in any case, if you support user fees then you have to also agree the Canada Health Act, which bans user fees, would have to be amended.