President-elect Dr. Ruth Collins-Nakai disputed that the medical association is endorsing private health care, as critics have charged.Thoughts?
The primary concern of physicians of Canada is that patients have timely access to quality care based on need, not ability to pay, said Collins-Nakai, a pediatric cardiologist in Edmonton.
Every resolution passed reflected the frustration of physicians not being able to provide that timely access to care that they so want for their patients, she said.
"Delegates have said clearly that they believe the best solution is to provide that type of access is through a public health-care system," she added.
Doctors have also adopted a list of "benchmark wait times," she noted. The list puts limited on how long patients should have to wait for key medical services such as cardiac care, cancer treatment or MRIs.
Nakai-Collins noted the motion on private health insurance that passed today merely reflects a recent Supreme Court decision, which upheld the right of Quebecers to turn to private health insurance if the public system fails them.
But she added: "Our feeling is that if the public system fails to provide timely care, then patients need to have alternatives.
"And one of those alternatives may be the private sector," she said, stressing the word 'may'.
In a story from ALPF (thanks, buddy!), I learned how David Wilkins, the new US Ambassador to Canada, got his job. The answer won't shock you. Indeed, it's the American way. Globe and Mail story here.
23 comments:
Sounds like the first, careful steps toward discrediting public health care and moving toward private health care. I don't know the intricacies of the Canadian budget, but why can't they just fund public health care better or make other changes to insure that more timely care is provided? I always think that if cash-strapped Cuba can do it, anyone can.
Sounds like the first, careful steps toward discrediting public health care and moving toward private health care.
This is a perennial debate in Canada, right up there with Quebec independence (and much more prominent lately). It's not necessarily part of a move to an all-private system; France's famous public system also has a private component, for example. For that matter, Canada's has private dentistry and optometry.
It's generally referred to as a "two-tiered" health care system. The debate generally comes down to: should people who can afford to be allowed to skip ahead in line? (That's, of course, a biased phrasing...)
I don't know the intricacies of the Canadian budget, but why can't they just fund public health care better or make other changes to insure that more timely care is provided?
One of the biggest problems Canada has right now is that doctors can make more money in private practice in the US than they can in public practice in Canada. As a result, a lot of Canadian doctors head south, leaving Canada with a very low doctor/patient ratio (I heard yesterday that we rank 26th out of 30 developed nations on that metric). A big part of the waiting times is simply the shortage of doctors.
Raising doctor pay to levels competitive with the US would be enormously expensive. Health care is already one of the biggest items in the Canadian budget, both federally and provincially.
Fortunately, we've been running a surplus lately, so that may help out.
I always think that if cash-strapped Cuba can do it, anyone can.
Yeah, but other services in Cuba suffer as a result. It's a trade-off: there's only so much money to go around.
I should note that I blogged about this here, after the Supreme Court decision on Quebec. There's a discussion in comments.
We discussed this topic on Rob's blog, here's a reprint of my view:
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One of the major problems with the American system is not that it's private, but that it's actually an even bigger bureaucratic mess then we have up here (crossing state lines involves huge red-tape), along with a lawsuit happy population that's driving the costs of insurance beyond reason.
A parallel insurance system like they have in the UK (and some other countries) is also undesirable. You end up with a cannabalized public system and an expensive private system.
I think the best option is something like the U.S. government does for its federal employees.
They choose an insurance carrier, and the government pays for a basic health care plan (that's standard across all the carriers that the government allows you to choose from). The employees can then purchase additional insurance to cover things such as semi-private or private hospital beds, etc.
I feel it would be the best of both worlds.
I always think that if cash-strapped Cuba can do it, anyone can.
Cuba's system is good by any Third World standard, but it doesn't come anywhere near the level of health care in the industrialized world. For example, as of 2003, there were only three MRI scanners in all of Cuba, whereas Toronto's Mount Sinai Hospital alone has two.
One of the biggest problems Canada has right now is that doctors can make more money in private practice in the US than they can in public practice in Canada. As a result, a lot of Canadian doctors head south, leaving Canada with a very low doctor/patient ratio (I heard yesterday that we rank 26th out of 30 developed nations on that metric)
I think I've mentioned this before, but its not the brain drain that's the main factor. Actually, a lot of doctors are leaving the system to take salaried, less stressful jobs within Canada. I'm marrying into a medical family now, I know.
In the late 80's and early 90's, governments across Canada did two things that caused this problem:
1) They cut the number of medschool placements dramatically, as they thought there was too many doctors. It takes a good decade or so for a doctor to become fully trained, so it affects the system years down the road.
2) At the same time, the provincial governments began clawbacks of fees that had already been paid out to the doctors (at least in Ontario). This was because the governments were bleeding red ink. Many doctors went bankrupt, or left the system in disgust when the government demanded repayments that averaged tens of thousands of dollars.
3) The costs of running private practices are increasing, while the government payout is flat. "Public" is a relative term. Actually, all doctors in Canada are private entities that just happen to have only one customer, the public health system (except when treating foreigners where they can bill the private insurance companies). Many people think doctors are rich. It's true a doctors salary is large, but out of his salary, he has to rent the office space, pay for all the medical supplies, pay the salaries of the office staff, etc. After expenses, an experienced doctor might take home about $130K a year, before taxes. That's not small by any means, but consider that I'll probably be making close to $100K byt the time I'm 30 as a software engineer. And I only have a Bachelor's degree, work 8 hours a day (with flex-time!), and have time to write this comment while sitting in my cubicle
Personally, I don't understand what all the fuss is about. The crusaders for public health care seem to turn a blind eye to the fact that we already have some private, for-profit clinics operating in all parts of the country and we already have some private health insurance to cover certain medical services. I have a Blue Cross card in my wallet right along side my Alberta Health card. The important threshold (and one we haven't come anywhere near crossing) is if we start providing duplicate services in the private and public system. That is so-called "two-tiered" health care and as far as I know, nobody is suggesting it, although Liberal politicians frequently smear Conservatives with it.
On an unrelated note....
It looks like I'll have to dig out my rabbit ears (antenna). I won't have cable until October. I think it's because we're the first people to move in.
I'll also be incommunicado next week (we take possession of the house on Monday).
Rob, have I mentioned lately that I really appreciate your perspective here? You provide balance and a viewpoint I wouldn't have otherwise.
Kyle: good luck!! Mazel Tov.
L-girl, glad to be of service. Truth is, although I frequent several Canadian conservative blogs, I don't enjoy the echo chamber ambience. I guess it's a quirk of my personality that I prefer to be lone rightwinger in a room full of liberals than to hang out with people who think the same way I do. I wonder if it's a sign of some undiagnosed neurosis.
[...] along with a lawsuit happy population that's driving the costs of insurance beyond reason.
But a recent study has shown this to be something of a myth. Not that insurance costs are beyond reason, but that the costs are driven by lawsuits. In the past five years, medical insurance premiums have gone up substantially -- but malpractise payouts have been pretty much flat.
We already have some private, for-profit clinics operating in all parts of the country and we already have some private health insurance to cover certain medical services.
True enough. The big worry is that a private, for-those-with-the-money system will drain resources from the public system; that the rich will get first-class care and everyone else will get the leftovers.
This is certainly not a necessary outcome of a mixed public/private system. There are a number of systems around the world which strike a reaonsable balance. It simply requires careful design and management to make sure that everyone has access to an acceptible quality of health care.
I suspect that one of the reasons why Canada is one of the few countries without a significant private component to its public health care system is we're next to the US, where the "private" system leaves a lot of people out in the cold. Millions are uninsured; chronic medical conditions go untreated among poorer people because it's too expensive to use the system for anything other than emergency treatment; etc. I think seeing that makes many Canadians very wary of "private" health care.
But a recent study has shown this to be something of a myth. Not that insurance costs are beyond reason, but that the costs are driven by lawsuits. In the past five years, medical insurance premiums have gone up substantially -- but malpractise payouts have been pretty much flat.
Sorry, I should clarify that. Malpractice insurance for the doctors has gone way up, even if the payouts haven't. That in turns means the doctors charge more, which drives up the patients insurance.
I wonder if it's a sign of some undiagnosed neurosis.
Ha! I wouldn't think so.
It's hard for me to think of you as "right wing". I know you are, in terms of Canada, but you're so moderate by American standards. Plus you have an open mind and are not given to shouting matches. Plus you said you'd vote for Hillary Clinton, and everyone knows she's a satan-worshipping commie.
Plus you said you'd vote for Hillary Clinton, and everyone knows she's a satan-worshipping commie.
I think she actually belongs to the New Reformed Church of Communist Satan-Worship; less communism, more Satan-worship. Also, I like her new hawkishness, it kinda turns me on. ;)
I think she actually belongs to the New Reformed Church of Communist Satan-Worship; less communism, more Satan-worship.
LOL
Also, I like her new hawkishness, it kinda turns me on. ;)
I take that back ;-)
I think Rob is kinda moderate by Albertan standards, for that matter.
....
Hey, I was googling for that gag electoral college map of the world that showed that Alberta voted for Bush, when I found this site...
Apologies Accepted
which is a response to this site,
Sorry Everybody.
My goodness. How on earth did I miss these? Almost as nifty as PostSecret...
Um, Where was I? Oh yeah, Rob. Yer a Mensch, Rob. You, Joe Clark, and my cousin Rob, who is also from Alberta. Fine conservatives all.
Oh yeah, that Apology site was terrific. Glad you finally saw it, better late than never. :)
I agree that Rob is a mensch.
I also noticed I wished Kyle Mazel Tov. I am approaching the leaving-New-York-and-becoming-more-Jewish syndrome. It's a well known phenomenon.
Well hey, look at that. Guess we don't have a socialist system after all. Who'd have thought? ;-)
To be fair to this whole thing, it is the best approach. A fully public system does run into funding issues from time to time. A fully private system creates a 'have/have not' situation as seen south of the border.
The public system has proven to work in the past, but allowing private practice is (a) nothing new - I know people who've been paying for back treatment for years - and yes that does fall under medical care; and (b) a means of providing an alternative to those who need certain care but cannot get past a long wait list due to lineups created by budget cuts (be it fewer doctors, fewer beds, or fewer hospitals altogether).
This is certainly not a sign that Canada will move away from the public system anytime soon - if anything, this latest move will relieve some of the pressure off the public system by allowing those who wish for faster care to seek other alternatives within the country (as opposed to heading south for care).
I think Rob is kinda moderate by Albertan standards, for that matter.
It's true, many Albertans, especially rural Albertans, are more socially conservative than me. However, among members of my peer group (i.e. overeducated, cynical, atheist thirty-somethings), I'm pretty rightwing, even in Alberta.
You, Joe Clark, and my cousin Rob, who is also from Alberta.
Oh no, me and Joe in the same sentence. I fear I may be drummed out of the corps now. Joe Clark is about as popular with Alberta conservatives as Pierre Trudeau is with Quebec separatists.
Yer a Mensch, Rob.
I'm blushing. :)
Ah, well, our peer group is going to change what's left of the world, once we pry the baby boomers' cold dead talons off it. Of course, we'll be in our seventies by then.
Poor old Joe. Unpopular he may be, but if he were the man currently leading the CPC he would be serving a second term as PM, I am firmly convinced. After all, the man was practically the only senior person in the Mulroney government that people still liked at the end of that era--there's a there, there.
Unpopular he may be, but if he were the man currently leading the CPC he would be serving a second term as PM, I am firmly convinced.
Except, he opposed uniting the Canadian Alliance and the Tories, so he would only be leading a party of a dozen or so members from the East Coast, rural Ontario and Calgary Centre.
I never understood why they chose Harper over Mackay.
Harper always looks like he's wearing the same makeup as Odo from Deep Space Nine. MacKay seems more amiable, and less like an alien.
MacKay didn't run.
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