It’s War, and over the Northwest Passage, no less:
My OHIP card would agree with you. :smack: What I meant was that Harper is more likely to turn towards a two-tier health care. Which again has way too many of it’s own problems to be a health-care cure-all.
Oh, I know, in fact a friend told me that “PAUL MARTIN GOES TO A PRIVATE CLINIC!!!” 
The trouble with the rise of private hospitals is this:
Where will all the doctors come from?
I think a lot of people will worry that most doctors currently working in public health care would jump ship for higher paying jobs at a private hospital. Essentially gutting the public system.
Has anyone found a way around this yet? (I’m genuinely curious.)
If they want out of the public health care system, what’s stopping them from just leaving the country and going to the U.S.? (answer: nothing. And plenty of them do). If a two-tier system keeps them here, isn’t that a good thing?
Plenty don’t. It’s kinda tough moving to a new country with a fistful of debt and being told you can’t get a credit card…
But it looks like Stephen Harper is making his own examination of the public health care system.
And there’s the problem with a Government run, rather than insured, health care system. Ontario is currently suffering from a lack of doctors due to a number of issues but a major one is restricted enrollment levels set by the province. Why are there not enough Drs.? Because government projections years back led them to believe that they wouldn’t need as many as they do right now. I would say that the universities and the college of physicians should be the ones setting enrollment and licensing requirements not the party of the day. There’s an interesting paper here (pdf) from the College of Physicians that is basically a pre-budget submission that makes some recommendations to the point you raised.
And then there’s the issue of what do people mean when they say “Two Tier”
a) Is it private clinics performing tests/procedures covered by your OHIP card (e.g. blood work/abortions)?
b) Is it private clinics performing test/procedures not covered by you OHIP card (e.g. Dentistry)?
c) Is it private clinics performing tests/procedures that are charged directly to the patient with no recourse to government coverage?
c) Is it government coverage of tests/procedures at independently operated facilities?
You’re never going to create a perfect system, but pretty much every country in the Western world has “Two-tiered” health care. Most decent European nations have a universal system without banning private care. Their systems seem to work as well, and sometimes better, than ours.
The Canadian obsession with banning private care is A) kind of silly, and B) sort of offensive. In my home town we had a situation where - I am not making this up - the city’s only MRI machine was being used after hours to perform MRIs on cats and dogs at $500-$1000 a pop, while human beings were on long waiting lists for MRI tests. So if you wanted Fido to get an MRI, you could pony up $1000 or whatever and at 5:01 PM they kicked all the humans out and Fido could get an MRI. But you could not pay $1000 to get an MRI for your sick child, because that’s PRIVATE HEALTH CARE, oooh, eeeeevil!
If I and a doctor voluntarily, of our own accord, agree that I should pay him some money in return for his services as a doctor, why is that a bad thing?
Because that will become the norm. Doctors are human too, and will respond for the money, resulting in preferred health care for the rich and the upper middle class. Just doesn’t seem right that I might have to wait six weeks for an MRI because I don’t have a thousand bucks to spare while Rickjay and his like jumps in to the front of the line, pushing my health care even further back.
If the wealthy Rickjay and his influential friend’s only option for quicker MRI’s was the same as mine, Then I would certainly welcome him and his friends to participate in the political debate to twist the arm of provincial and federal governments to make more MRI’s available. Then we ALL win.
I can easily accept the airlines providing more comfortable seats and services for those who are willing to pay the extra. I can easily accept the preferred guaranteed loading on B.C. ferries to those who are willing to pay the extra. These services however are luxuries that we don’t need. Health care is a necessity for all of us however, and I don’t want to see it compromised.
As opposed to the current system where you would either wait six weeks anyway, or was six weeks plus a day because I was already on the list ahead of you.
First of all, there’s no end to that.
Secondly, you;re asusming in the first quote above that the existence of private health care will necessarily bite into the public system. That A) isn’t consistent with the reality in countries that do it this way and B) as we have very clearly seen, cutting off private care in fact reduces the total amount of health care available. Canada loses doctors and nurses every year because of the restrictions placed on them by the government.
Third, you simply don’t have the moral right to tell a human being “You may not engage in trade to get health care.” It’s just wrong, a violation of the most basic sort of freedom, as a Quebec court has already ruled. If the public system has its warts, fix them. Don’t use force to coerce people into finding alternatives to further your agenda. Would you ban private schools so as to better support public education? That’s a necessity for all of us. Should private wells and septic tanks be banned so as to force people to use public water supplies and sewers? You could make a pretty good argument that fresh water and sewers do as much for health as hospitals.
So don’t compromise it. It’s possible to have both. France - frequently cited as having one of the best systems in the world - has private clinics. So do Australia, Italy, and Germany. Their public systems have not vanished.
Look, the rationing argument is silly, because private systems ration services just as public ones do. The difference is that in the private system, rationing is based on ability to pay while in the public system, rationing is on a first-come, first-served basis.
Rickjay: Amen.
Canada already has a ‘two-tier’ health care system. The second tier is the United States. Every year, thousands of Canadians travel to the U.S. to get treatment they can’t get here, or to bypass waiting lists. And they’re not all rich people. If you’re a 65 year old person with a bad hip, and you need a hip replacement to be mobile again, how much of your life savings would you spend to avoid a 2-year wait for an artificial hip? At 65, you might not have too many years of active lifestyle ahead of you, and you probably don’t want to spend 2 years in a wheelchair. So people cash in their RRSPs or take mortgages on their houses to go to the U.S. for surgery.
If we allowed private clinics here, the two-tier option would be cheaper, and it would keep doctors and health care money in Canada.
As for all the doctors moving into the ‘for-profit’ tier, as Rickjay has said, in countries that have two-tier systems this just doesn’t happen. There are plenty of doctors who like working in the public sphere. If there weren’t, all our doctors would be in the U.S. now, since there is still big demand for doctors there.
The net effect of a two-tier system could easily benefit low income people, by injecting more money into the health care system. A private clinic with their own MRI machine offloads patients from the public machines. Taking all the rich people off of surgery waiting lists moves everyone else up on the queue. And we might find that this isn’t just available to rich people - supplemental insurance plans will no doubt spring up that will allow people to choose the case they want, if they are willing to pay the premium.
Ironically, they view us the same way when it comes to prescription drugs.
In that case, Canada is more like Wal*Mart.
Like Walmart, Canadian drug stores can sell you the goods at a lower price (in some cases) because they represent, through the Canadian feds, a monopsony - a purchaser so big and powerful it can dictate lower prices to the supplier. (Of course, you don’t buy your drugs from the Canadian government - you buy them from a drug store, like Shoppers or Pharma Plus - but it’s the government doing the bargaining.) Walmart does the same thing; they can dictate lower prices to their suppliers, and so can charge ultra-competitive prices. Again, in some cases, not all.
American drug stores near the border are therefore competing with what is, in effect, a cartel of drug stores with an untouchable advantage in their ability to, indirectly, demand lower costs and therefore pass on prices to the end consumer that no U.S. drug store could dream of.
Errr…Canadian drug prices have nothing to do with any monopsony, since there isn’t one. It’s straight up price regulation by the government.
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That price regulation, however - as with the regulation of any price to points below its market-clearing price - effectively makes the Canadian government the de facto purchasing negotiator of the drug retail industry, at least with regards to newer, patented drugs (I assume everyone understands we’re not talking about Aspirin.) Bear in mind that the PMPRB can’t just willy nilly lower the price of a patented drug to absurdly low levels or else the manufacturer won’t be bothered to sell it.
The PMPRB cannot prevent a drug from being sold on the basis of price; they CAN, however, order the company to pay up if they find it’s been charging excessively.
Well, that’s fine as far as it goes. But it is simply not the case that patent drug prices are what they are in Canada because of a monopsony. The PMPRB does not negotiate prices with the drug companies, or try to get as good a deal as it can. It follows a formula intended to establish a “fair” price. This is unlike the market effects of an actual monopsony in fundamental ways.
Question: Does the Conservative Party favor Canadian military involvement in Iraq, or with the GWAT? I ask because I just came across this pre-election editorial on the website of SF writer Spider Robinson (an American expatriate and naturalized Canuck) – http://www.spiderrobinson.com/election2006.htm:
At the time, the Conservatives were sharply critical of the Liberal government’s refusal to support the US-led attack on Iraq. Their position on the issue was similar to that of Blair or Howard.
The current platform, as put forth during the recent campaign, includes a pledge not to join the Iraq misadventure. In any event, the question is largely moot. With the Liberal party leadership vacant, and the general mood of the public, there are only a very few issues that the Opposition would bring down the government over. Sending troops to Iraq is one of those few.
As for the greater war on terror, Canadian troops have been and will continue to operate in Afghanistan.
In fact, we’re sending 2,000 troops to Afghanistan, and the soldiers that have already been there have been in combat regularly. Canada participated in the war against the Taliban, and 3 Canadian snipers working with three U.S. Special Forces spotters rescued an entire company of 101st Airborne who were trapped by Taliban forces. The Canadians were awarded Bronze Stars by the U.S. military.
Also, at least until the end of Operation Anaconda, Canadians had the highest kill ratio of any combatants in Afghanistan. They are doing serious work there. It’s not a token force.
It’s interesting that one of Harper’s first statements after being elected was to threaten the United States over Canadian territorial rights. The Conservatives have argued for a long time that one of the primary responsibilities of a government is to protect its sovereignity, and the Liberals have downsized our military so much that we can’t defend Canada’s territorial waters. As a result, U.S. warships have moved back and forth through what Canada claims is their territory, without permission or notice. Harper plans to add several armed warships to patrol Canada’s northen sea lanes to keep the Americans out.
It’s a smart move. It quiets those critics who claim that Harper will be George Bush’s laptop, while keeping the Conservative pledge to increase Canada’s military strength.
So, under a Harper government, will Canada’s military commitment abroad expand or contract?
Rattling your saber over a place even the Inuit won’t go is a “smart move” by Canadian standards?