Supreme Court of Canada

[August1991]

What I am saying is, like it or hate it, our Canadian courts are making calls they have no right to make. It should be decided by Canadians in a democratic way, not by our judges. These decisions awfully seem like the communist way of doing things.

Redneck, I don't disagree with you. I meant that if the Supreme Court were a political party, then it would get my vote. I too think parliament and not the Supreme Court should decide these issues. IOW, parliament should have dealt with this ages ago.

Keep in mind though what the Court's main decision was in this case. It said that two (in fact three) Quebec laws were in contradiction: Quebec's Charter and Quebec's health acts. The Supreme Court is supposed to find such contradictions.

----

Allowing people to die because they have to wait YEARS for their first appointment to a specialist is grossly irresponsible and quite frankly makes our healthcare system look like crap.

But allowing people to die because they have no money will make our health care system look better?

These two extreme viewpoints get to the heart of the issue: should we decide who gets medical treatment according to personal wealth or willingness to wait. In fact, the choice is not as stark as that but these two extremes are reference points.

At first glance, deciding who gets health care according to personal wealth seems grotesquely unfair or unequal. In fact, such a system will be much more fair or equal than a system of queues and waiting lists.

The Soviets designed an entire society on the same basis as Canada's health system. It is a system where prices either don't exist or are entirely bureaucratic. Money coming into a hospital is completely disconnected from the services going out. Financial accounting is meaningless. Queues and waiting lists are the norm.

Such systems don't work. They are inefficient and utlimately unfair and unjust. This is what the Supreme Court just pointed out.

We do not live in a world of such extreme choices. If this decision holds, in several years, our health system will be a mixed bag of private and public insurance schemes and private and public clinics and hospitals. We will get more services without having to pay more overall, and those services will be more fairly distributed.

This is largely the European evidence.

[Guest eureka]

The Sovoets did not design an entire system on the same basis as our healthcare system. Our system is a user pay system through taxes in which the poorer in society pay proportionately more than the wealthy. Our healthcare system is also not a centrally planned and administered. We could do with more, though, as for the government buying of all pharmaceutical needs.

The Supreme Court is entirely acting within its mandate to rule on the issue. It is just unfortunate that emotion seems to have overcome reason for some members in coming to erroneous conclusions. As I said earlier, I do not intend to read the judgment, but it is instructive to read the verdicts of some who have.

It seems that the Court ignored testimony of some experts and made no reference in its judgment to their evidence - such as evidence adduced with respect to European systems. At the same time, it accepted anecdotal evidence of, for one, a golfer. It also appears that the complainant's delay was largely of his own making.

Evidence was also presented on the European systems which, as I have maintained are not superior to the Canadian. Our system needs fixing of problems that are probably more the result of federal-provincial bickerong that anything. We need more health care workers and doctors. Canada has a poor ratio of doctors to population.

Evidence was presented that proved that resources in the puvlic sector are reduced everywhere there is a parallel private system. It is instructive to note that Not Romanow, Kirby, or Mazankowski proposed anything other than single tier care. The names of the two latter are much misused.

Something needs to be done about healthcare but it is not the introduction of private care that is needed. A good start would be in the quashing of the jealous rivalries over control and jurisdiction.

[cybercoma]

And that fact still remains that there are no "real" prices in healthcare in Canada. Doctors are not being paid what their services are worth, nor can they charge what they're worth. It's supply and demand the absolute basics of economics. These people spent thousands of dollars on almost a decade of post-secondary education to get where they are (and they must constantlyl re-educate themselves to keep up with current technology and studies) and they're forced to make wages that the government says they must make. This isn't exactly fair to those doctors, is it?

Our healthcare system is NOT a shining example of how healthcare should be run around the world. The problem isn't simply a doctor shortage because people aren't going into those programs, it's a doctor shortage because they realize they can make better money in private systems a hop, skip and a jump away in the United States. Don't fool yourselves. I live in Windsor, Ontario and we hear about it doctors going over to Detroit or other parts of the states constantly. You don't suppose they're doing this so they can truly be paid what their services are worth? You'd be kidding yourself if you thought otherwise.

And we're still not mentioning the waiting lists, which the Supreme Court originally ruled against and I find it absurd that the eureka is going to lay the blame on the patient as if it's status quo that people create their own wait times. Waiting times are a problem and a common problem at that and people die as a result of it. We have limited services and a huge demand for them. We solve this problem in every other area by having a free market determine the price.

The concern with medicare is that people could possibly die as a result of waiting or not being able to afford services. People die everyday because they can't afford food or shelter and we serve those people through charity.

Imagine if groceries were treated the same as our current healthcare system. People would be waiting in lines at the grocery store for a loaf of bread and a bag of milk because of the huge demand for such products. Meanwhile, farmers are being paid what the government dictates. Having the government ration out food supplies will ensure everyone has food, but it will not stop people from going hungry.

People are rewarded for their productivity and hard work with their wages. With that money that has been earned through the personal and social responsibility of labour, persons are allowed to do whatever they please. Typically people will pay their rent before they go out and waste all their money on beer or videogames. If they don't, who's responsibility is that? Should the government be responsible for them or should people have some sort of responsibility themselves?

If people do things that put their health at serious risk (overeating, smoking, drinking, drugs, extreme sports, etc....) should they not bear some responsibility for their actions? Those who live healthy lifestyles and take care of themselves will be afforded the benefit of not having to spend as much on healthcare, but currently they're still forced to pay the same amount as those who are using the system all the time because of their irresponsibility.

A two-tier system is going to benefit everyone but it will also reward those who take responsibility for themselves through working hard and living healthy. It will relieve the burden on the public system and force it to compete for patients with private care clinics. This competition will make executives realize they can't make 30-40% increases in their pay for one year, while allowing the hospitals they run crumble.

With better public hospitals and less of a demand for their doctors and services the waiting lists will eventually be reduced and we'll all be better off. Your public insurance will still cover the things that it already covers and you'll actually be able to use it in the private facilities. Even when going to the United States for care you can present an OHIP card and get service. This idea that people will be dying in the streets if there is a two-tier system is nothing more than scare tactics.

Now let's talk about the government possibly using the "notwithstanding clause" to completely undermine our legal justice system...

[Guest eureka]

What I find absurd is that you continue to ignore facts and evidence. The Supreme Court, in essence, ruled only that waiting times are unfair and that the Health laws are in violation of the Quebec Charter of Rights. There is no "Notwithstanding" Clause to use.

Evidence given was that averwhere there is two tier medicine, there is a weakening of public healthcare - that is everywhere.

Ever investigation of the Canadian system carrie dout with the possible exception of anything the Fraser Institute has cooked up, shows that Canada's present system is superior. We need to fix its problems not throw out the baby.

Doctors in Canada are close to the highest paid in the world. Your argument about their worth is nonsense. To alk of their going to the States is quite irrelevant. America has the highest paid by a very long way and they are the highest paid because of the undemocratic nature of the society and the system where monopoly and oligopoly rule with the assistance of government.

Doctors whose only interest ins in money will go there, whatever. They are not something to be pointed to as "seeking their worth." They are greedy entrepreneurs.

There is not the slightest doubt that the major problem in the Canadian system is shortage of professionals. Canada has a much higher ratio of patients per doctor than the US and, incidentally, Russia is much better fixed than the uS in that respect. Russia's doctore are not all clamouring to go to America.

We need to fix the system and to make it live up to the fairness that is its premise not to give it over to greed.

BTW, the claimant in the SCC action is partly at fault for his own misfortunate. Apparently, his own anxiety about the procedure led him to cause delay. Hr also had the surgery before he started the action and the doctor involved is a known enemy of public healthcare and a supporter of private greed.

[kimmy]

There have been some good messages in this thread! I will have to reread some of them. However, one that I think was especially good was Adelle's:

The Supreme Court deals with only the legal issue in isolation, not the social or political issue that exists or may arise. These other issues not only do not concern it but also are outside its jurisdiction. People may call them ‘activist’ but they can only present their opinions and interpretations within the framework of existing laws. If a law, once it is presented to them, if found to violate a greater law or is being used incorrectly, then it is their duty to correct the problem. The people and politicians must then deal with any fall out. You would think that the lawyers that run the country could make laws that pass all three tests.

The Supreme Court has simply said this isn't right. Fix it.

Many of the people who in the past have defended the Supreme Court's independance and integrity and their authority to interpret the constitution, are now the people who are bitching about this particular Supreme Court decision.

I suspect that some of the people who've in the past equated the "notwithstanding" clause with heresy on issues like gay rights or abortion or language, will be advocating for the use of the "notwithstanding" clause in this particular situation.

Basically, the feel I'm getting is that a lot of people are of a mind that "We support the Charter and the Supreme Court (.... as long as we agree with their rulings.)"

At a basic level, it comes back to this:

If someone has earned their $60,000 through only the most meritudinous of activities, they should be able to spend it on a ridiculous SUV... but not on surgery to save their own life?

Right.

Apparently... not "right."

I believe that ultimately it comes down to an argument that August1991 has been having on and off with others for weeks: is healthcare a "zero-sum" enterprise?

The Sweal's view is that our hypothetical patient had better just go spend his $60,000 on an SUV or a huge vacation or something, because if he's spending it on healthcare, then he is causing harm to another patient.

I would agree with his position if I did believe that healthcare was "zero-sum", but I'm far from convinced.

I believe that an increased role for private healthcare providers would cause an immediate influx of capital from entrepreneurs investing in much-needed infrastructure. (in the earlier discussion with The Sweal, I offered a hypothetical example where I won the lottery and spent my proceeds on a shiny-new MRI machine.)

The counter-argument, no doubt, is that qualified healthcare professionals will be snatched away from the public system to work in the private system. I think maybe that is *partly* true, but only partly.

First off, while the discussion tends to center on doctors who take many years to fully train, we tend to forget that many of the allied healtcare professionals take far shorter amounts of time to train. The technologists who will be operating my hypothetical imaging equipment clinic are graduates of 2 year technical school programs. As are respiratory therapists and many other professionals. I believe that the licenced practical nurses who would form most of the staff at private extended care facilities are trained in just a year or two. So, essentially, if we took action right now, we could have a generation of new allied health professionals ready to enter the field before the private enterprises are even ready to open their doors.

I also believe that increased private presence in the healthcare field would help retain health professionals in Canada. I believe that American operations have been "poaching" Canadian-trained doctors and nurses for years. I believe that private healthcare operations in Canada could provide an alternative for the professionals considering moving to the states. Aside from creating more infrastructure and opportunities, private organizations could offer stock-options and other incentives for professionals who might otherwise go to the US in search of rewards. In highschool I talked to a respiratory therapist about the field; he informed me that many graduates of the program at his school immediately head off to Saudi Arabia to work for a few years. Why? Lots of job opportunities, huge money, no taxes. Maybe private clinics in Canada could provide job opportunities and financial incentives *without* the risk of being beheaded.

And I believe that before too long the number of doctors and surgeons and anaesthesiologists in Canada would also catch up to the increased demand created by private providers. Immigration and increased retention would bring us to equilibrium before very long, and it would be an equilibrium where the *supply* of this scarce commodity "healthcare" is at a higher level than it is right now.

So there you go, that is my argument as why healthcare *isn't* a "zero-sum" equation. React to me.

-k

[Argus]

Ever investigation of the Canadian system carrie dout with the possible exception of anything the Fraser Institute has cooked up, shows that Canada's present system is superior. We need to fix its problems not throw out the baby.

Our system is superior? In what way? To whom? And don't mention the US, please.

So our system is better than, oh say, the Germans? The French? The Belgians? In what way? Are our waiting times lower than theirs? Does our system cover more than theirs? Do we have a lower infant mortality rate? What? Why is ours better? And if our system is so obviously better why is it not one European country, all of whom have been pretty much ruled by Socialists the last two decades, has opted to emulate it? Not one.

There is not the slightest doubt that the major problem in the Canadian system is shortage of professionals. Canada has a much higher ratio of patients per doctor than the US and, incidentally, Russia is much better fixed than the uS in that respect. Russia's doctore are not all clamouring to go to America.

Because Russian doctors would not be permitted to work in America due to their low level of skills and training. We have a shortage of doctors and nurses because of government decisions taken to limit intake into medical and nursing schools. I believe the idea was that the fewer doctors, the fewer claims for fees.

[Argus]

The reality is that this is the situation today, just as it was yesterday, just as it will be tomorrow.

So we fix it, not succumb flapping our hands feebly.

<{POST_SNAPBACK}>

What incentive is there to fix the system when it already works fine - for them? Not only do they and their families get to the front of the lines but at least for the Liberals and NDP, it makes a great issue every election. If the system was working perfectly they'd not be able to wrap themselves in the flag and claim to be defending the system from those evil Tories who keep wanting to change it.

[The Terrible Sweal]

The reality is that this is the situation today, just as it was yesterday, just as it will be tomorrow.

So we fix it, not succumb flapping our hands feebly.

<{POST_SNAPBACK}>

What incentive is there to fix the system when it already works fine - for them? ... and claim to be defending the system from those evil Tories who keep wanting to change it.

If there' no incentive for a government to improe he system because they get taken care of, why would the tories have any more incentive to improve it???

But quite apart from paranoia, how can you consider it an improvement to expand and intensify the very thing you identify as a problem??

[Argus]

The reality is that this is the situation today, just as it was yesterday, just as it will be tomorrow.

So we fix it, not succumb flapping our hands feebly.

<{POST_SNAPBACK}>

What incentive is there to fix the system when it already works fine - for them? ... and claim to be defending the system from those evil Tories who keep wanting to change it.

If there' no incentive for a government to improe he system because they get taken care of, why would the tories have any more incentive to improve it???

Because the Tories, like the NDP, actually care about more than power. They are actually running for office in order to change things, to improve things, as they see it. The Liberals, of course, long ago abandoned anything but power and money as motivations.

But quite apart from paranoia, how can you consider it an improvement to expand and intensify the very thing you identify as a problem??

?

[The Terrible Sweal]

At a basic level, it comes back to this:

If someone has earned their $60,000 through only the most meritudinous of activities, they should be able to spend it on a ridiculous SUV... but not on surgery to save their own life?

Right.

<{POST_SNAPBACK}>

...

The Sweal's view is that our hypothetical patient had better just go spend his $60,000 on an SUV or a huge vacation or something, because if he's spending it on healthcare, then he is causing harm to another patient.

Hardly. (You drew me over here to respond to imputed strawmen? Kinda disappointing.)

I would agree with his position if I did believe that healthcare was "zero-sum", but I'm far from convinced.

I believe that an increased role for private healthcare providers would cause an immediate influx of capital from entrepreneurs investing in much-needed infrastructure.

This position presumes that money to pay for more health care exists in private hands. So,

if the money to pay for more heallth care exists in private hands, then why not tax it sufficiently to pay for the level of need? After all, the hospital doesn't care who pays for the technicians salaries.

[The Terrible Sweal]

If there' no incentive for a government to improe he system because they get taken care of, why would the tories have any more incentive to improve it???

Because the Tories, ... , actually care about more than power.

HAHAHAHAHA!!! HAHAHAHA!!!

HAHAHAHAHAAAAA!!!

But quite apart from paranoia, how can you consider it an improvement to expand and intensify the very thing you identify as a problem??

?

Your answer to why we should allow full scale two-tier health care is 'because we already have two-tiers'. How will intensifying two-tier health-care solve that problem???

[jimrahn]

I argued before the Romanow Comission that Canadians needed a constitutional amendment, similar to the Charter of Rights and Freedonms, to fix the healthcare system, in fact, as the only way to fix the healthcare system.

You must be kidding. People are suffering and dying on waiting lists because the gov't is forced to prioritize how the limited amount of public funding get spent. The supreme court says this violates a person's rights and your solution is to make this suffering and dying constitutional?

Our system cannot be fixed without changing the way it works. It is a monster that WILL consume every tax dollar that we spend on it because the cost of healthcare increases as the amount of money available to spend on it increases.

A leader with vision and imagination could re-structure the system to allow a private system to supplement the public without undermining the public system.

For example, rules could be put in place that only allow private care only if the public system is not able to provide care in a timely fashion (i.e. any surgury within a few weeks). You could add a special 'luxery' tax to private health care fees that are used to fund the public system.

<{POST_SNAPBACK}>

I appreciate anyone who takes the time to stay on top of this issue, regardless of their opinion on it. It's important. But let me make sure I understand this...

You want Canadians to fully support the public system,essentially as it now is, but bring alongside a private, for-profit system; force people to use the private system because the public system is in such bad shape, and then still tax them again for using that system?

You really think that's a better solution?

Look at the situation right now.

The Supreme Court has in essence said that healthcare is a basic human right.

The reason people are suffering and dying is that there is no law establishing that right before the federal and provincial governments. Ergo: Suffering and dying is already constitutional in Canada by defaut, since there is no law protecting Canadians against it.

A constitutional amendment would make governments accountable for healthcare delivery. Allowing private healthcare to supplement public healthcare just lets governments off the hook further.

I don't agree with your argument about the present system consuming every tax dollar available. And I'm not sure how private system brought along side the public system would make the overall cost of health care, public and private, less expensive anyway. If healthcare is opened up to free market forces there's nothing to prevent the private system from sucking up every available dollar either. Not only that, there's a good chance the public system will be forced to keep pace, making all services, both public and private even more expensive.

What makes people think the present system is unsustainable anyway? Because the government tells them it's unsustainable? Sorry, but I don't believe everything the government says, regardless of their political stripe.

Saying that Canada can't afford the public healthcare system is like saying Canadians can't afford healthcare period. I think that's nonsense I don't care which government says it, it's baloney.

Apply the logic to anything else and it falls flat. It would be like saying we never should have stopped Hitler back in the '40s because fighting World War ll was just too expensive, that the war was "unsustainable".

Well it was expensive, in lives as well as dollars, but here's the important factor: it was a national priority. Canadians fully funded it through tax dollars, bonds and victory loans because they believed in the importance of it and guess what? We won. Not only that, the economy grew substantially while we were doing it.

Using the same analogy, it would be like someone suggesting that yes, maybe it's important to stop people like Hitler bent on world domination, but if we had a private contracted-out army to fight alongside Canada's national army it would be a cheaper war to fight. It's an argument that is utter nonsense.

Besides, the standard of living in Canada is more than high enough to support a fully-funded, publicly administered, accessible healthcare system. It should go without saying Canadians who don't have to pay out-of-pocket for a private system (on top of a public system) will have more disposable income. Or maybe some people who support a private system are hoping employers will throw it in as a work benefit. Well, correct me if I'm wrong, but if an employer is stuck with paying for added health premiums out of your paycheck or out of their bottom line, guess what they'll choose? Bingo! Again, less disposable income for Canadians. Like it or not, that's the way business has to operate to survive.

I think it's time to stop looking to the private sector for solutions that are in our best interest. We won't find them there. Let's stop allowing governments to make excuses. It's high time we hold them accountable for commitments to the health and well-being of Canadians. It's time to make healthcare a constitutional right.

Cheers!

[kimmy]

At a basic level, it comes back to this:

If someone has earned their $60,000 through only the most meritudinous of activities, they should be able to spend it on a ridiculous SUV... but not on surgery to save their own life?

Right.

...

The Sweal's view is that our hypothetical patient had better just go spend his $60,000 on an SUV or a huge vacation or something, because if he's spending it on healthcare, then he is causing harm to another patient.

Hardly. (You drew me over here to respond to imputed strawmen? Kinda disappointing.)

I drew you over here mostly to be sure that you had read (and had the opportunity to respond to) my argument as to how allowing private participation in healthcare will expand the capacity of the system and improve access for everyone, even those who continue to utilize public facilities. Your lack of response to any of that is telling.

If I've straw-manned you, I'm terribly sorry. It wasn't my intention. I made an assumption.

My assumption was that the *only* reason a "classical liberal" would have for preventing that poor man from spending his $60,000 to save his life would be if spending that money was contrary to the public good (ie, forces others farther back in the waiting list, or similar.) There might be other ideological reasons, but none of them are very consistent with "classical liberalism".

I would agree with his position if I did believe that healthcare was "zero-sum", but I'm far from convinced.

I believe that an increased role for private healthcare providers would cause an immediate influx of capital from entrepreneurs investing in much-needed infrastructure.

This position presumes that money to pay for more health care exists in private hands. So, if the money to pay for more heallth care exists in private hands, then why not tax it sufficiently to pay for the level of need? After all, the hospital doesn't care who pays for the technicians salaries.

If the money exists in private hands, why not just grab it and take it for the public system? Uh, I think the Supreme Court decision addresses that, don't you?

-k

[The Terrible Sweal]

I drew you over here mostly to be sure that you had read (and had the opportunity to respond to) my argument as to how allowing private participation in healthcare will expand the capacity of the system and improve access for everyone,

What I've seen so far is that you think that would happen, but not why or how.

Your lack of response to any of that is telling.

I responded with the point about money in private hands, discussed below.

My assumption was that the *only* reason a "classical liberal" would have for preventing that poor man from spending his $60,000 to save his life would be if spending that money was contrary to the public good

Yes.

(ie, forces others farther back in the waiting list, or similar.) 

Not chiefly.

This position presumes that money to pay for more health care exists in private hands.  So, if the money to pay for more heallth care exists in private hands, then why not tax it sufficiently to pay for the level of need?  After all, the hospital doesn't care who pays for the technicians salaries.

If the money exists in private hands, why not just grab it and take it for the public system? Uh, I think the Supreme Court decision addresses that, don't you?

? No.

And you haven't addressed it now either.

[Guest eureka]

Yes, Argus, by inference, and in some cases, direcrly, every study of note has said that the Canadian sysstem is superior to the others.

The problem we have is that we have allowed it to rust and have to get to work to remove the rust.

That does not mean changing access to one that differentiates between people according to wealth or social position.

Or do you think that the value of a life is measured by the size of a bank account?

[Argus]

If there' no incentive for a government to improe he system because they get taken care of, why would the tories have any more incentive to improve it???

Because the Tories, ... , actually care about more than power.

HAHAHAHAHA!!! HAHAHAHA!!!

HAHAHAHAHAAAAA!!!\

Childish response. So you're saying the Tories are not ideologues, do not actually care about traditional things like family, have no particular axes to grind or desires to change the system? Then why are you so afraid of them?

But quite apart from paranoia, how can you consider it an improvement to expand and intensify the very thing you identify as a problem??

?

Your answer to why we should allow full scale two-tier health care is 'because we already have two-tiers'.  How will intensifying two-tier health-care solve that problem???

It is a problem because only the wealthy and powerful have any access to a way around the system. If you allow more private funding then most health care alternatives will be open to at the very least, the middle class. In fact, if you base additional health care insurance costs on the presumption that OHIP will pay its regular amount, and that the additional insurance tops this up to a higher level, then the premiums should be fairly affordable. All that extra money going into health care will atract additional suppliers. All those people satisfying their need through these additional suppliers will be removed from the public waiting lists.

[Argus]

Yes, Argus, by inference, and in some cases, direcrly, every study of note has said that the Canadian sysstem is superior to the others.

Name one. Tell me how it is better than the Swedish or Finnish systems, or Belgian or French systems, or Spanish or German or Japanese systems. Better access? Faster access? More access? What?!

[Argus]

I don't agree with your argument about the present system consuming every tax dollar available.

Oh not every dollar. There will always be dollars available for graft and corruption.

Besides, the standard of living in Canada is more than high enough to support a fully-funded, publicly administered, accessible healthcare system.

In theory, I agree. But not this one. This one is broken. It could be fixed. But the problem is that there are two chief forces in this country regarding health care. The one on the right wants to bring in lots of private health insurance. The one on the left wants to keep the present system exactly as it is. The one on the right could concievably add more health care services, and make it easier for more people to obtain health care. The one on the left will lead to nothing but further stagnation, longer waits and higher taxes. Now if there was a force which conceded that the present system needs to be changed.... but there isn't.

The present system is unaffordable simply because, in large measure, no one in it has any incentive to keep costs low. That especially includes the health care consumer. Nothing costs them anything. There is no incentive to minimize their consumption. If they want to go to the doctor because they have the sniffles, then they'll damned well go to the doctor. Again and again and again. Who cares what it costs? Who even KNOWS what it costs? And drugs... we'll take whatever we want, and doctors will prescribe whatever we want. Who cares what it costs? That is especially true of seniors, who are vastly overmedicated, in no small measure because they don't pay for their medications.

It should go without saying Canadians who don't have to pay out-of-pocket for a private system (on top of a public system) will have more disposable income.

Presuming they can work. I know an electrician who needs treatment on his arm. But he can't get it until he gets and MRI. And the wait for an MRI is about six months, give or take a month. Or... he can go to Quebec and get one in a week for $800.

Let me try another. A couple of months ago I went through a very long night of intense back pain. Why? Because none of the private clinics which provide reasonably quick treatment and prescriptions are open all night. Why? Because they can only accept OHIP payments, and OHIP doesn't pay extra for midnight shifts. Therefore, the private clinics can't pay their doctors and nurses extra. Therefore, there are no all night clinics. There are hospitals - with six or eight hour waits, though, not an option. If you allowed the private clinics to charge, say, ten bucks, just a lousy ten bucks, on top of what OHIP pays them, they could afford to pay their doctors and nurses a premium to work overnight. Suddenly, you could get to see a doctor at three in the morning! Wow! What a concept!

You tell me how this would harm the public system? Maybe it would actually help it in that more people would go to the clinic, and fewer to the emergency room. Maybe there wouldn't be six to eight hour waits then. Maybe the waits would only be three or four hours?

In fact, if they could charge small fees for additional services, they could then provide those services profitably, and maybe there'd be even fewer people waiting in those long lines at the emergency rooms. We're not talking about charging a fortune, just ten, twenty, thirty bucks, maybe even a hundred for something like setting a broken bone (9 hour wait at local ER a few months back). That sort of thing. Those who could afford it get faster service. Those who can't, go to the ER, where, because of the clinics, they get faster service too. Everyone wins.

I think it's time to stop looking to the private sector for solutions that are in our best interest.  We won't find them there.  Let's stop allowing governments to make excuses.  It's high time we hold them accountable for commitments to the health and well-being of Canadians.  It's time to make healthcare a constitutional right.

You don't need to make health care a constitutional right. You just need to vote against people who don't improve health care. The last four elections, the Liberal Party has howled to the four winds their dedication to the public health care system. Have they fixed it? Nope. Have they made a serious effort to fix it? Nope. Do they have any plans to fix it? Nope. But in the coming election I absolutely guarantee you they'll be championing their dedication to public health care once again, and many people will shuffle dutifully out to the polls to vote them into power again - to uhm, protect health care.

[The Terrible Sweal]

HAHAHAHAHA!!!  HAHAHAHA!!!

HAHAHAHAHAAAAA!!!\

Childish response. So you're saying the Tories are not ideologues, do not actually care about traditional things like family, have no particular axes to grind or desires to change the system? Then why are you so afraid of them?

Laughter is an honest response to a ridiculous argument.

I'm not saying tories are not idealogues. I'm saying their idelogy is not consonant with social or human weal.

...How will intensifying two-tier health-care solve that problem???

... If you allow more private funding then most health care alternatives will be open to at the very least, the middle class. ... All that extra money going into health care will atract additional suppliers.

Okay, let me be serious here for a moment and ask the same of you. If the money exists to pay for more health care, and the desire exists for more health care, why not tax it and provide that healthcare universally?

[Guest eureka]

I have named them, Argus. Romanow, Kirby, & Mazankowski. All plumped for single tier no matter the variables.

All studies also showed that wherever ther is "two tier" there is leakage away from the public system.

Britain is a good example of how not to "fix" things. Their system has gone from top to mediocre and, not long ago, the Blair government was forced to provide a huge amount of additional funding to try to get it working again. About as much immediate money as has been proposed here for the long term fix.

[August1991]

Okay, let me be serious here for a moment and ask the same of you. If the money exists to pay for more health care, and the desire exists for more health care, why not tax it and provide that healthcare universally?

While the money appears to exist now, it won't exist if you try to tax it.

*Bangs head against wall*

TS, let me simplify down to the lowest level possible: I have time to wash dishes, and the desire exists to have cleaner dishes, so why are you surprised when I don't come to your house to wash dishes?

[Canuck E Stan]

There is a public/private two-tier model that actually works in Canada - the education system. No one gets all riled up about the fact people can send their kids to Upper Canada College or Rundle College or whatever private school they chose. Everyone in Canada has access to the public school system - it is universal, paid for by taxes, and accessible to all. Those who feel it is not optimum or the best system, or that it is not meeting their kids' needs, still have to pay their taxes to support it, but can opt out and pay extra for their kids to go elsewhere. Just like the public medical system, the public education system does have its drawbacks - big class sizes, many kids with ADHD and learning disabilities needing help, tons of ESL kids who struggle, whatever - but the option to go elsewhere and pay money for a supposedly "better" or more elite experience does not evoke the outrage that privately available medicine does - and is there really a difference?

As long as those seeking private health care continue to pay taxes to support the public system, who cares? Resources for public medicine will continue at the same rate. Can you imagine if private education was the pariah that private medicine is? People would be ranting to shut down private schools as un-Canadian and too American. Tommy Douglas and his legacy would be invoked (except it would be Egerton Ryerson.) People should get beyond knee jerk, emotional reactions and try to find workable solutions to systemic problems.

What has to happen with public health care is stopping abuse of the system - people with sniffles going to emergency rooms costing $300+ per visit when they really need a family doctor. People going to doctors to get antibiotics when they have a virus. Old people being prescribed multiple medications that interact improperly and cause problems. There needs to be accountability and people have to realize even if they don't hand over a cent, their doctor's visit is NOT free.

If Canada had a pro-active wellness system instead of a reactive illness-focused health care system costs would be contained.

We need some big changes and not people ruling out options based on ill-founded ideologies and fear of boogeymen.

[August1991]

What has to happen with public health care is stopping abuse of the system - people with sniffles going to emergency rooms costing $300+ per visit when they really need a family doctor. People going to doctors to get antibiotics when they have a virus. Old people being prescribed multiple medications that interact improperly and cause problems. There needs to be accountability and people have to realize even if they don't hand over a cent, their doctor's visit is NOT free.

IMV, that was a very, very good post, Canuck.

The fundamental difference between our education system and our health system is that the clientele for public education is of fixed size - kids under 16 or so. And over the past 30 years or so, this clientele has been shrinking.

The only way to expand demand for public education services is to ask for special treatment (special education). This doesn't mean that public education doesn't eventually fall victim to all non-market bureaucracies - an increasing disconnect between what an employee is doing and what a supposed recipient of a service wants. It just means that public education has been able to survive longer.

In the case of health services, there is no natural limit on the demand side. Anyone can find a reason to see a doctor. We started with a "sort of" private system that "sort of" worked in the 1960s and over time, it has turned into an absolute monster.

The next time you see a doctor, ask her how many forms she has to complete each time she sees someone, and how many meetings she has scheduled every month. Ask her if there is an ongoing "reform" or "restructuring" that, according to administrators, should improve things. Milan Kundera explained all of this much better than I can. You can also try Franz Kafka.

[jimrahn]

Argus, sounds like you've put some thought into this,but you're also making some unsubstantiated claims.

I don't think anyone is saying leave the system as it is. And I'm now sure how you can make a statement that most seniors are over-medicated.

Cheers

Edited June 13, 2005 by jimrahn

[jimrahn]

Okay, let me be serious here for a moment and ask the same of you. If the money exists to pay for more health care, and the desire exists for more health care, why not tax it and provide that healthcare universally?

While the money appears to exist now, it won't exist if you try to tax it.

*Bangs head against wall*

TS, let me simplify down to the lowest level possible: I have time to wash dishes, and the desire exists to have cleaner dishes, so why are you surprised when I don't come to your house to wash dishes?

<{POST_SNAPBACK}>

Money doesn't just disappear through taxation. There's a difference between money and disposible income.

Let me use the same analogy: My three year old son is sick with a fever, I need to take him to the doctor, which I can do, having paid for improvements to the public healthcare system, although it has meant I have less money to spend on things like nice dishes.

There are also other people in my neighbourhood who want to have lots of nice dishes, so don't support public healthcare, prefering to spend the money on dishes.

Unfortunately, when they get older and are no longer able to work to pay their own health expenses their dishes will not be adequate to pay for healthcare in their old age, since the private insurance companies, having saked these people all their lives, will be able to buy all the dishes they themselves want and to heck with the people who paid for them in the first place...