Ford's welfare rollbacks

[turningrite]

43 minutes ago, cannuck said:

Typically, we are discussing one tiny aspect of a much, much larger problem that never seems to be understood.

EVERY country has some degree of social policy and programmes.  So, let's start by realizing that they are a necessary part of a humane society.  The question is: how much social programme spending can any particular country afford?  THAT depends upon just how wealthy and wealth creating the economy of any country in question might be.  

Bottom line is: we simply can NOT afford the level of government waste, massive debt and cost of being some kind of dumping station for the displaced of the world.  We need to get our house in order and start not just "working", but working productively - something few seem to understand.   We can not just keep frittering away our children's future by squandering natural resources.  The social safety net in this country is at a level that would be considered in many places as living very high on the hog.  Heck, with our fairly good sick care system, even the #2 economy in the world has probably less than half of its population that can afford to get anything even close to what we get in medical benefits (worth mentioning that most of the rest of the old G7 are at least as well off as we are for sick care).   I think Ford is being very astute in backing out of the grand social experiment.  When we have no more federal and provincial debt, THEN we might be able to consider such folly (as then it would not necessarily BE folly).

I was sort of with you throughout most of this until I came to the health care part. Have you had to deal with a serious health care problem, as I have, only to be told that as Canadians we're essentially uninsured and without health care rights and lacking universal access despite demonstrated medical need?  Look at the seriously disabled guy in London, ON, who's suing merely to obtain humane care. I believe we should be able to buy private insurance to deal with these issues as the public system is stretched to its limits and the cost to taxpayers to right the ship would be so enormous as not to be feasible. But I also now believe the entire social support system should be moved to a similar model, with eligibility attached to contributions. I think that's the only hope for maintaining adequate services in this country.

[cannuck]

8 hours ago, turningrite said:

I was sort of with you throughout most of this until I came to the health care part. Have you had to deal with a serious health care problem, as I have, only to be told that as Canadians we're essentially uninsured and without health care rights and lacking universal access despite demonstrated medical need?  Look at the seriously disabled guy in London, ON, who's suing merely to obtain humane care. I believe we should be able to buy private insurance to deal with these issues as the public system is stretched to its limits and the cost to taxpayers to right the ship would be so enormous as not to be feasible. But I also now believe the entire social support system should be moved to a similar model, with eligibility attached to contributions. I think that's the only hope for maintaining adequate services in this country.

I was not trolling for you, but I DID know that would raise you eyebrows - or hackles.

Yes, not personally, but both within family and close friends and both in Canada and the US.

I watched my racing team mate - a loyal follower of the socialist party (unionized teacher) die because of slow access to diagnose cancer that metasticized to liver when he was in early 40s.  Watched my best friend - who's wife teaches integrative medicine - have a big run in with the big C - but due to their deep links into the sick care system, and even deeper pockets - he went South and bought service simply not available here.  On the other side of the border, one of our key employees has a wife with very serious illness - and we keep that company running since if we close down (as we should) he will NEVER get adequate or equivalent coverage from a new insurer.

Our system is flawed, that is for sure.  In all other G7 countries public insurance can coexist with private delivery both publicly and privately paid.  We have a fair bit of skill and quality in care overall, but IMHO, when there is a need for fast and heavy intervention, in many places we just don't respond appropriately.  It seems we have put medicine on some kind of plateau, and pay a lot for sick care without demanding accountability for results, but the whole thing is so distorted by Big Pharma and the LLL (Legal Liability Lottery) from South of the border, that time and money is wasted doing things that do not need to be done - at the cost of things that really need to be done.   Add to that up here of trying to maintain the government/CP&S monopoly on service delivery of in scope insured procedures and we are on the wrong track.

We already HAVE the benefits according to contributions that you propose.  IF you have the financial wherewithall, you can simply go outside of the Canadian system and pay for the very best of diagnostics (Mayo, for instance) and very best of service delivery (several centers in the USA).  Even though I am otherwise somewhere right of Ghenghis Khan on most issues, I can NOT imagine scrapping the whole universal sick care system we have - just improving it tow work as well as it does in most of the rest of the former G7 world.   The key is to realize the sick care is not (or SHOULD NOT BE) a business, but a social service.   That cost(s) we taxpayers a pile and I strongly object to throwing the doors open to hundreds of thousands or even more than a million people who did not in any way contribute to it, and in many cases will never do so.  It is, for example, a HUGE benefit to small business startup NEVER to have to worry about the cost of sick care insurance for employees - and important to realize that small business is by far the greatest contribution to job growth and wealth creation - and it won't exist without appropriate framework to facilitate startups.

Finally, the is the issue of health care.  We have only a tiny bit of it.  For instance: one of the most critical things we need to know is what, why and how to eat - and in Canada the Food Guide is a really good resource - but a really small and poorly promoted one.  It is vastly more cost effective to pay to keep people healthy than to let the medical, drug, insurance and legal business cash in on our collective ignorance of health care and wellness.

Edited August 15, 2018 by cannuck

[turningrite]

12 hours ago, cannuck said:

IF you have the financial wherewithall, you can simply go outside of the Canadian system and pay for the very best of diagnostics (Mayo, for instance) and very best of service delivery (several centers in the USA). 

That's pretty much my point. We already have a two-tier system in that those who are financially able to do so can obtain adequate health care outside of Canada. I was referred to a U.S. hospital for diagnostic assessment related to a rare disease but when I became aware of the potential extent of the uninsured liability, as the Ontario health system approval I had obtained would have covered only a portion of the cost, I had to assess the feasibility of choosing between this option and no care at all and the latter won out. I was told by a representative for the American institution that it considers Canadians to be "uninsured" patients. I contacted my work benefits provider and was told that its "extended care" benefits cannot provide employees with the kind of coverage required for planned medical care or treatment outside the country because it is essentially illegal to sell this kind of insurance in Canada! Wow! And Canadians think they have access to universal coverage for necessary medical care? Think again. It made me question my support for our so-called safety net.

[eyeball]

1 hour ago, turningrite said:

I contacted my work benefits provider and was told that its "extended care" benefits cannot provide employees with the kind of coverage required for planned medical care or treatment outside the country because it is essentially illegal to sell this kind of insurance in Canada! Wow! And Canadians think they have access to universal coverage for necessary medical care? Think again. It made me question my support for our so-called safety net.

What is the actual reason for it being illegal?  I doubt its intent is to outright thwart people from getting medical care despite that being a consequence. I suspect some sort of trade restriction designed to protect or give advantage to insurers.  This could be more of a free (and lack thereof) trade issue due to someone tilting the economic playing field in one direction or another.  I'm reminded also of the way the shortage of doctors in our system is used to undermine publicly-funded heath-care when its actually occupational protectionism that's preventing the system from hiring more doctors.

Whenever I try to imagine how or why a privatized health-care system might deliver less skewed results I look to veterinary care for example.  Take the special dietary food I have to buy my cat, I can't buy it at a normal pet food store because they can't buy it from the company that makes it - you have to go to a vet to get it prescribed and as I'm finding get re-prescribed periodically at the cost of taking the cat to the vet.  If it feels like a racket it probably is. The pet-food store would love to sell it to me   I've also seen how a veterinarian association used its clout to shut down a well liked and employed local practitioner thereby forcing people to drive a hundred km or more to seek help.  A vet explained to me that things like their cat-food monopoly help subsidize their operation and without which might not allow them to stay in business.  I told him to go tell it to our local unemployed vet.

Edited August 15, 2018 by eyeball

[turningrite]

11 minutes ago, eyeball said:

What is the actual reason for it being illegal?  I doubt its intent is to outright thwart people from getting medical care. I suspect some sort of trade restriction designed to protect or give advantage to insurers.  This could be more of a free (and lack thereof) trade issue due to someone tilting the economic playing field in one direction or another.  I'm reminded also of the way the shortage of doctors in our system is used to undermine publicly-funded heath-care when its actually occupational protectionism that's preventing the system from hiring more doctors.

 

My understanding of the private insurance prohibition in relation to what's viewed as necessary medical care is that it's a function of the Canada Health Act, which stipulates a single payer monopoly for medically necessary health care services. I believe the underlying assumption is that all medically necessary care is provided within the government-funded model. But that's increasingly not the case and we're living under a dangerous illusion if we fail to comprehend this. The  representative for the American hospital to which I was referred noted that government funding coverage for patients from Ontario has declined considerably in recent years. I was led to understand that patients from some other provinces fare better in this regard. But what kind of "universal" coverage is this, unless perhaps the term has become a euphemism for universally inadequate or universally diminishing coverage?

Edited August 15, 2018 by turningrite

[Michael Hardner]

On 8/3/2018 at 5:06 PM, Bonam said:

1. Not sure how the presence or lack of white people on your team says anything about a labour shortage. First, that's anecdotal, as you well know. Second, most of the people on your team are Canadians, I'm sure. Third, Corporate IT is ripe for more automation in the coming years, anyway. 
 

2. Conventional political parties have largely failed Western countries over the last decade or so. Individual liberties have been eroded, populations have become more bitterly divided over social issues, corruption has proliferated, etc. The sooner the political status quo that permits all this to continue is shattered, the better. 

1. We are bringing people in from India to fill jobs.  If 'automation' comes then there will be some other tech to replace it.

2.  'Largely failed' is hyperbole.   Liberties being eroded - I can't think of any significant examples.  So that seems like hyperbole.

I'm fine with populism's general plaints, but let's not pretend they're real.

[cannuck]

It is pretty much luck of the draw when it comes to dealing with rare or exceptional cases.  You either get a specialist and facility that can do it well and figure out how to get it under in-scope coverage or you don't.   If the latter, you either have to do it out of pocket (and out of country) or do without.  If you have routine illness or injury, you will get adequate, if slow care in most places.  BUT: if you don't get decent practitioners, your access will be poor or denied.  It isn't that much different in the US: if you don't have a gold plated benefits package (and decent sick care premiums alone can be several thousand $$$ per month per family).  You may be in rural bum frick nowhere and if the local hospital tries diagnosis and treatment of difficult cases, the results are no different from an indifferent Ontario.  Patient ends up dead.   Even if you can get to a really good specialist, you may not get coverage, especially when managed by an HMO.

[bush_cheney2004]

3 hours ago, eyeball said:

 .... I'm reminded also of the way the shortage of doctors in our system is used to undermine publicly-funded heath-care when its actually occupational protectionism that's preventing the system from hiring more doctors.

 

Only indirectly...provincial governments purposely limit the number of new residents and practicing doctors because they do not want more procedure billing against very constrained budgets.   An increase in adequate numbers of doctors would collapse the system.

The pending departure of net revenue producing Saudi residents impact on the Canadian health care system is making this more apparent.

 

Quote

In Canada, the provincial governments tightly control the number of medical residents – medical school grads who spend three to five years working in Canadian hospitals, qualifying as doctors. Residents are paid relatively poorly, earning something in the area of $65,000 a year, but their services are a vital part of the health care system.

In 2018, the provinces funded 3,308 residency positions. Those residents eventually become fully practising doctors, and governments, which strive to contain medical budgets in our publicly insured system, are always anxious to limit the number of doctors who will eventually be billing the system. Money ultimately trumps public need.

http://www.cbc.ca/news/opinion/saudi-medical-residents-1.4784798