Day on Health Care

[Urbane]

I believe we have to start thinking out of our current box about health care and I believe Stockwell Day points us in the right direction:

Stockwell Day: Time to face taboo of 'two-tier' health-care
Discussing alternative funding for health care has been politically impossible - but now it's impossible to ignore, writes Stockwell Day
By Stockwell Day, Special to CBC News Posted: Sep 7, 2011

Ever wonder why one of the truly life and death issues of public policy, namely alternative funding of health care, is avoided at all costs by almost all politicians?

Simple. It's their own political lives which they properly know are at risk if they dare raise the matter of alternative funding.

Every elected person understands full well that she risks banishment or ostracization by her party, her constituents and maybe even family members should she dare touch the Holy Grail of Canada's supposedly "free" health care model.

Questioning this apparently infallible doctrine that weakly supports our fiscally failing health care system is a career-ending decision in the minds of even the bravest elected members.

There is a terrible irony here.

Never has there been more caution about raising this topic, and never has its raising been more needed.

The health funding Fear Factor is certainly nothing new.

Flashback to Jean Chretien's snap election call in 2000. Early in the campaign one of our Canadian Alliance MP's was misquoted to the extreme as suggesting we needed a "two tier" health care system.

The MP never suggested it, our policy manual did not endorse it, and the news releases we put out to push back the distortion completely denounced it.

All to no avail. The Liberals assailed us (smartly, but falsely) daily, at every turn of the campaign. Any other messages we tried to push forward were buried amid the avalanche of cries of a "secret" agenda on health care.

During the 2000 Leaders Debate, Stockwell Day tried to put down charges he was out to introduce two-tier health care. Now, he says, it's a debate we must have. CP PHOTO The din did not subside until the Leaders' Debate. I was able to snag a national headline-grabbing photo by holding up a card during the debate with the words "No Two Tier Health Care" firmly refuting the attack.

That coast-to-coast visual helped, somewhat, to put the matter to rest. Proof of that was revealed in real-time polling conducted by Ipsos-Reid as the televised debate was in progress.

Results were presented on-air by Ispso-Reid immediately after the debate for the five topic areas selected by the debate organizers. One, obviously, was health care.

The pollster explained that the majority of viewers had awarded me first place in 4 of the 5 debate segments, and second place (to the NDP) in the portion on health care.

Even though we managed to somewhat dissipate the effects of being accused of wanting to dismantle Canada's universal health care system, we had paid dearly for it.

Rising costs threaten provincial budgets
Part of that price continues to be paid today. A warning to those seeking office: even breathe about needing to change the system and you'll get scorched.

Well, another scorching is taking place. It is the burning up of an ever-growing portion of every province's budget by health care costs.

Let me say at this point that I believe we probably have the finest and most dedicated health care practitioners of any in the world.

It is not the fault of the doctors, nurses and other professionals that costs continue to rise disproportionately. It also is not all about the demographics of the aging population.

Even technology with all of its wondrous advances is not responsible for the upward driving costs. Nor is technology alone the key factor that can keep costs manageable.

The key systemic and fatal flaw is the funding system itself.

By stubbornly refusing to allow the development of a modern system that allows those who can willingly afford it to buy services, while still providing properly for the rest of us, we are dooming every provincial budget.

The day will soon arrive when politicians will have to say to citizens,"What other essential services are you prepared to go without due to the growing and voracious appetite of a health care system we cannot properly feed?"

Canadian health-care dollars heading south
Right now, thousands of Canadians, unwilling to bear the risks or pain of rationed health care services, are crossing the border with their hard-earned cash.

They are giving untold millions of dollars to U.S. doctors, U.S. nurses, U.S. hospitals and U.S. research facilities.

These Canadians would much prefer to see their money go to improving our system here at home.

It can absolutely be done while still providing free and universal health care to all other Canadians, and at improved levels of service.

However,if we continue to demonize every MLA or MP who wants to at least look at the options and possibilities then we condemn ourselves to higher costs, higher deficits, higher taxes and lower levels of care.

Even the socialized systems of European nations allow for fee for service (translation: two tier) systems.

What's it going to be? More pain and rationing for all?

Or a way of allowing a fresh revenue stream to provide needed oxygen to a system already on life support?

[NAB]

I believe Day, and anyone who promotes private sector involvement in health care to the extent that those who can afford to pay be allowed to do so carte blanche, need to think it through further. Particularly how going down that road might (probably would) negatively affect the health care resources available to those who cannot afford to pay. In many ways, it is happening already.

Nab

[Urbane]

I believe Day, and anyone who promotes private sector involvement in health care to the extent that those who can afford to pay be allowed to do so carte blanche, need to think it through further. Particularly how going down that road might (probably would) negatively affect the health care resources available to those who cannot afford to pay. In many ways, it is happening already.

Nab

You only need to look to Europe, Australia, or New Zealand to find health care models where private and public co-exist. And if you look at Canadian health care outcomes we tend to find ourselves behind those countries. Even if you don't agree with that assessment what would your solution be to the growing cost of health care? Raise taxes? Allow wait times to increase? Some additional form of rationing? Other? You are certainly in the majority from the polls that I've seen. By and large people want to keep our system as is (private and profit are two very bad words) but I've yet to hear much in the way of solutions.

Right now someone can go to the False Creek clinic and have any number of procedures done (colonoscopy for example). Those people get out of the public line up and head over there and pay. Those who do so can afford it and the public line becomes shorter. The doctors there (generally) work in the public system as well. So what's wrong with that system? Should those people who want to have a procedure done at False Creek have to leave the country should they not want to wait?

I have a friend who was having severe headaches and the doctor told him he should have an MRI or CT scan (can't remember which) to rule out a brain tumour. When asked how long it would take before having it done the doctor said it would be a few months. He said if it were him though he'd fly to Alberta and have it done at a private clinic there. And that's what my friend did. Now I know that private MRI clinics have been popping up (Image MRI for example) so it would seem that things have changed in the last few years and that there are now more private options in BC. Again, is that a bad thing?

Asking Day and others to "think it through" is certainly good advice Nab but so should others who think that the path we're on is sustainable without changes. I look forward to hearing your suggestions and those from others.

[The Green Barbarian]

Many people I know are heading south for health care as the wait times here are ridiculous - I know one guy that was put on a two year wait list for a procedure so he went down to Seattle and had it done for $200 on a weekend. There are pros and cons to every system, so why can't we at least open our minds and study other systems? I remember talking to one lady who was protesting "two-tier" health care, so I asked her why, and she said "because if the rich get to pay for their treatment then they will "jump the cue" and get treatment ahead of me". I found this puzzling, so I said "well if they pay, and get treatment, doesn't that open up spots faster for those who can't pay, so we all win?" She just shook her head and said "I just don't want them to get ahead of me". So then I understood the mentality - its not about fixing the system, or helping people, it's all about everybody having to suffer equally, no matter how much money they have, at least in some people's minds, as this makes the system truly "fair". Well life isn't fair, so let's just fix what is broken, and not worry about things being "fair". That mentality is a dead zone mentality.

[Oxl3y]

Many people I know are heading south for health care as the wait times here are ridiculous - I know one guy that was put on a two year wait list for a procedure so he went down to Seattle and had it done for $200 on a weekend. There are pros and cons to every system, so why can't we at least open our minds and study other systems? I remember talking to one lady who was protesting "two-tier" health care, so I asked her why, and she said "because if the rich get to pay for their treatment then they will "jump the cue" and get treatment ahead of me". I found this puzzling, so I said "well if they pay, and get treatment, doesn't that open up spots faster for those who can't pay, so we all win?" She just shook her head and said "I just don't want them to get ahead of me". So then I understood the mentality - its not about fixing the system, or helping people, it's all about everybody having to suffer equally, no matter how much money they have, at least in some people's minds, as this makes the system truly "fair". Well life isn't fair, so let's just fix what is broken, and not worry about things being "fair". That mentality is a dead zone mentality.

For once we agree on something. My father had a cancer scare and instead of screwing around here waiting until it got bad enough to become priority he paid to go down to the Mayo clinic and have it dealt with. I am not blind to the possibility of implementing such a system here in Canada being fraught with problems though.

If you had private doctors who charged for services and public doctors that worked within the healthcare system why would any doctor want to work in the conceivably lower pay position of public? I suppose government incentive to stay public would have to be attractive.

Regardless of the problems though I do believe this would start reducing wait times and benefit everyone it seems strange that people are so resistant.

[Urbane]

Many people I know are heading south for health care as the wait times here are ridiculous - I know one guy that was put on a two year wait list for a procedure so he went down to Seattle and had it done for $200 on a weekend. There are pros and cons to every system, so why can't we at least open our minds and study other systems? I remember talking to one lady who was protesting "two-tier" health care, so I asked her why, and she said "because if the rich get to pay for their treatment then they will "jump the cue" and get treatment ahead of me". I found this puzzling, so I said "well if they pay, and get treatment, doesn't that open up spots faster for those who can't pay, so we all win?" She just shook her head and said "I just don't want them to get ahead of me". So then I understood the mentality - its not about fixing the system, or helping people, it's all about everybody having to suffer equally, no matter how much money they have, at least in some people's minds, as this makes the system truly "fair". Well life isn't fair, so let's just fix what is broken, and not worry about things being "fair". That mentality is a dead zone mentality.

Exactly right GB. Some of the same people who would rather us all suffer equally when it comes to health care are the same people who talk about the gap between rich and poor. They would be happier if we were all poor rather than see people like Jimmy Pattison with all that money. Some of that thinking is philosophical but I think jealousy plays a role as well.

[Urbane]

Many people I know are heading south for health care as the wait times here are ridiculous - I know one guy that was put on a two year wait list for a procedure so he went down to Seattle and had it done for $200 on a weekend. There are pros and cons to every system, so why can't we at least open our minds and study other systems? I remember talking to one lady who was protesting "two-tier" health care, so I asked her why, and she said "because if the rich get to pay for their treatment then they will "jump the cue" and get treatment ahead of me". I found this puzzling, so I said "well if they pay, and get treatment, doesn't that open up spots faster for those who can't pay, so we all win?" She just shook her head and said "I just don't want them to get ahead of me". So then I understood the mentality - its not about fixing the system, or helping people, it's all about everybody having to suffer equally, no matter how much money they have, at least in some people's minds, as this makes the system truly "fair". Well life isn't fair, so let's just fix what is broken, and not worry about things being "fair". That mentality is a dead zone mentality.



For once we agree on something. My father had a cancer scare and instead of screwing around here waiting until it got bad enough to become priority he paid to go down to the Mayo clinic and have it dealt with. I am not blind to the possibility of implementing such a system here in Canada being fraught with problems though.

If you had private doctors who charged for services and public doctors that worked within the healthcare system why would any doctor want to work in the conceivably lower pay position of public? I suppose government incentive to stay public would have to be attractive.

Regardless of the problems though I do believe this would start reducing wait times and benefit everyone it seems strange that people are so resistant.

In France, for example, all doctors have to work a certain number of hours each week in the public system. A system like that might address the issue you raise.

[Bagotricks]

Stockwell Day is a crook. He opened up his own lobbying type firm that helps people get government contracts - but its legal - because technically hes not in government anymore. Don't worry, the ethics commissioner said its not illegal. It's simply a arbitrator appointed by the government to investigate itself and clear itself of any wrongdoing without having a real judge do it. Harper appointed Mary Dawson to the office of ethics commissioner. She was a Tory who worked with Brian Mulroney. Now she has been given this magical wand and title to repeatedly clear the Tories of conflict of interest charges without a trial. So its legit, Stockwell can hook you up.*wink*

http://www.vancouversun.com/news/Tory+m ... story.html

So a super rich, connected and protected guy embedded in greasy politics says "Hey paying for healthcare isn't THAT bad". He is worth millions now - no biggie to have "people that worked hard for their money" side step lines and get faster service right? All his friends in the same income bracket agree with him so he cant be wrong!

Right. This is just classic frog in the jacuzzi public relations. We wont get "too" upset if they dismantle the public health care system slowly. Steven Harper said during his time with NCC ( that secret ultra right wing lobby group that he headed before becoming PM ) that he wished to dismantle public health care, which is still part of the NCC's mandate.

Don't give them a inch. Resist at every turn. Everyone is equal in this country in terms of healthcare. Sorry you have to wait in line behind the welfare recipient, it must be annoying that money cant buy everything.

Instead of lobbying for a two teir system - improve the one we have. But that's not really what its about is it? There is alot of "private money" just waiting to open shop and charge Canadians for health care services. I wonder if they are employing Stockwell Day's little firm to get their business models into Canada?

[Urbane]

So Bago, what is it about the French system that you think doesn't work? By many accounts it's at or near the top in terms of health care delivery and health care outcomes while Canada is well down the list, just above the USA. If the surveys are correct and France has a system that provides better care would you still opt for our system for philosophical reasons?

[The Green Barbarian]

For once we agree on something. .

Really? I find it hard to believe we can see eye to eye on such a contentious issue and not agree on a lot of other things too. Weird.

[The Green Barbarian]

Instead of lobbying for a two teir system - improve the one we have.

I believe that is what we are all talking about here - but how do we improve it Bago? It is easy to use soundbite politics like Jack Layton in the last Federal election, and constantly bleat "more doctors and more nurses" but that's just nonsense. This issue isn't as simple as that. So other than bleating the tired old socialist blather about "more doctors and more nurses" and "more money for health-care" what are some of your concrete proposals to "improve the one we have"? Stockwell isn't a crook, and your assertion is essentially libel, but at least he is trying to think outside the box, because the box we are in right now stinks to high heaven, and the stench is only going to get worse.

[wthwyt]

I am not against a 2 tier system, as long as it's a win win for both those who can pay as well those who are unable.

Tier 1 is for everyone no matter their ability to pay.

Tier 2 is for those who have financial ability to pay for medical services.

My biggest concern is with Doctors & Nurses jumping out tier of 1 to tier 2, leave tier 1 right back were we are now. Line ups due lack of surgeons (Doctors) and staff (Nurses), as well the level of care. Due to best & brightest surgeons (Doctors) and staff (Nurses) going to tier 2 leaving those in tier 1 average or below because they will only have to deal with poor people.

[Bagotricks]

The main problem with employing a business-type, capitalistic approach to health care is the two are incompatible.

How can you make any money if someone invented a pill that costs 25 dollars that kills all the cancer cells in your body? There goes the standard 500,000 dollar cancer "treatment" regime. There is no profit in cures, just ask AIDS drug manufactures.

There is no money to be made in efficient health care, only money saved. If you keep it social and efficient, it can run like a dream. If you privatize it - the only ones suffering are going to be the people that cant afford the "good tier" heath care system which is inevitable ( you go to school and have a choice - work in a public hospital and make 250k a year, or open a private firm and make 250k a month, all the good talent will be sucked off for profit. ) and the the medical system itself.

In a private system there is no motivation to keep things efficient and actually CURE people. Or better yet preventative medicine ( stop them before they even get to the hospital )as long as people have $$$. That would be like a oil company providing free bicycles to people that live in cities to help curb high gas costs! The last thing they want to do is cut off their steady supply of sick people in a for-profit hospital. Sure kids - keep on eating sugar and fat all day! Its a complete conflict of interest.

People talk about the American health system like its a wet dream when in reality its a bunch of snake oil salesmen in white coats backed by billion dollar drug companies. Sure, we can let you live a extra 6 months - for a few million dollars we will provide THE WORLDS BEST medical services - doesn't matter if your going to be a drooling vegetable the whole time - DON'T GIVE UP HOPE ( as long as you have the $ we will assist you in your denial that your going to die )

I am not a health care expert, but for improvement starters I would suggest the workers over at the interior health office don't take 4 coffee breaks a day and walk over to Tim Horton's every 1.5 hours, dismantle "Interior Health" all together and I'm sorry, but every car in the parking lot over there is a Lexus or a Porsche. There is plenty of fat to trim. As well, we have a huge burden of old people to deal with. They outnumber us. The medical system worked up until the sick and old started outnumbering the young healthy taxpayers.

I am so sick of these whiners bitching they have to wait 6 months for a knee surgery and because of the wait their golf season is ruined (and because of which their quality of life is down and therefore they will die sooner so it becomes "life threatening") If your life is in danger you don't have to wait, that is a fact. Orthopedic surgeons are too busy fixing broken legs from car wrecks to get you back on the golf course in a timely fashion. Apparently Stockwell is suggesting the solution is to bribe the doctors with more money and private firms - and let those car wreck victims deal with rookie fresh out of school doctors while all the REAL professionals have all gone over to private firms where the big bucks are. Sounds great *shudder*.

Call it what you will but it is nobodies fault that they get sick. Everyone in Canada, rich or poor, young or old is afforded the SAME quality health care. When you have millionaires butting into line while others suffer in line ups - that is hardly equal. On the flipside, I don't favor making well off people "pay more" for their services. That wouldn't be fair either. Everyone's equal - that is the key. One system, just improve it.

[Urbane]

The main problem with employing a business-type, capitalistic approach to health care is the two are incompatible.

How can you make any money if someone invented a pill that costs 25 dollars that kills all the cancer cells in your body? There goes the standard 500,000 dollar cancer "treatment" regime. There is no profit in cures, just ask AIDS drug manufactures.

There is no money to be made in efficient health care, only money saved. If you keep it social and efficient, it can run like a dream. If you privatize it - the only ones suffering are going to be the people that cant afford the "good tier" heath care system which is inevitable ( you go to school and have a choice - work in a public hospital and make 250k a year, or open a private firm and make 250k a month, all the good talent will be sucked off for profit. ) and the the medical system itself.

In a private system there is no motivation to keep things efficient and actually CURE people. Or better yet preventative medicine ( stop them before they even get to the hospital )as long as people have $$$. That would be like a oil company providing free bicycles to people that live in cities to help curb high gas costs! The last thing they want to do is cut off their steady supply of sick people in a for-profit hospital. Sure kids - keep on eating sugar and fat all day! Its a complete conflict of interest.

People talk about the American health system like its a wet dream when in reality its a bunch of snake oil salesmen in white coats backed by billion dollar drug companies. Sure, we can let you live a extra 6 months - for a few million dollars we will provide THE WORLDS BEST medical services - doesn't matter if your going to be a drooling vegetable the whole time - DON'T GIVE UP HOPE ( as long as you have the $ we will assist you in your denial that your going to die )

I am not a health care expert, but for improvement starters I would suggest the workers over at the interior health office don't take 4 coffee breaks a day and walk over to Tim Horton's every 1.5 hours, dismantle "Interior Health" all together and I'm sorry, but every car in the parking lot over there is a Lexus or a Porsche. There is plenty of fat to trim. As well, we have a huge burden of old people to deal with. They outnumber us. The medical system worked up until the sick and old started outnumbering the young healthy taxpayers.

I am so sick of these whiners bitching they have to wait 6 months for a knee surgery and because of the wait their golf season is ruined (and because of which their quality of life is down and therefore they will die sooner so it becomes "life threatening") If your life is in danger you don't have to wait, that is a fact. Orthopedic surgeons are too busy fixing broken legs from car wrecks to get you back on the golf course in a timely fashion. Apparently Stockwell is suggesting the solution is to bribe the doctors with more money and private firms - and let those car wreck victims deal with rookie fresh out of school doctors while all the REAL professionals have all gone over to private firms where the big bucks are. Sounds great *shudder*.

Call it what you will but it is nobodies fault that they get sick. Everyone in Canada, rich or poor, young or old is afforded the SAME quality health care. When you have millionaires butting into line while others suffer in line ups - that is hardly equal. On the flipside, I don't favor making well off people "pay more" for their services. That wouldn't be fair either. Everyone's equal - that is the key. One system, just improve it.

Where do I start? First of all, you say that private health care doesn't work. Well, a private-public system works very well in many other countries so you're wrong. And the notion that doctors and nurses would have no motivation to cure people in a private system displays a very dark view of the human race.

And I was frankly shocked to read your description of those in pain because they're waiting for knee surgery. Wow! That is incredibly heartless of you. I've personally know a few people who have been on painkillers for months as they wait for knee or hip surgery. Call it bitching and whining if you like but I hope you or I never have to go through it. Bad karma on your part!

"Fixing" the present system means more money - lots more money because you're not going to find enough cuts by shaving salaries of administrators. 54% of British Columbians just voted NO to the HST which was providing more revenue so as some people keep looking at ways for OTHER people to pay the bills it will make it increasingly difficult to "fix" the current system. I don't want the American system either. In fact, that would be the last thing I would want here but I do want to look at alternatives to our present system. It's so disappointing to see so many people have an automatic knee-jerk reaction against a public-private system which works so well elsewhere.

[The Green Barbarian]

Urbane - having lived in Australia I can honestly say their system is miles ahead of ours. In every way. I was very impressed.