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2022 CPC Leadership Discussion: Et tu Redeux

Except that's not the result privatized healthcare would achieve, and this just shows how much of the propaganda you've been swallowing that the private health care and insurance industries are trying to feed you.

A single-payer, government-funded healthcare system offers the potential to reduce costs and improve health outcomes for everyone. By eliminating the complex web of private insurers, administrative costs can be significantly reduced. The streamlined system allows for simplified billing and lowers overhead expenses, enabling more resources to be allocated directly to patient care. Negotiating bulk purchasing of medications and medical supplies can also lead to significant cost savings. Moreover, a single-payer system prioritizes preventative care, emphasizing early interventions and proactive measures that can prevent costly chronic conditions in the long run. This approach promotes a healthier population, reducing the need for expensive treatments and hospitalizations. Additionally, a single-payer system provides equal access to healthcare, ensuring that everyone, regardless of their socioeconomic status, can receive necessary medical services. This eliminates disparities in health outcomes and creates a more equitable society where the health and well-being of all citizens are prioritized. Ultimately, by reducing costs and improving access to care, a single-payer healthcare system has the potential to generate better health outcomes for individuals and create a healthier, more prosperous society as a whole.
So, we have the second highest per capita health care costs in the world (behind the US), with some of the worst outcomes/wait times in the OECD.

When do you suppose the dream of a single payer health care is going to pay off?
 
To counter myself; some times push comes to shove; but more than not I think people are trying to keep up with the jones'.

Don't you think 500,000 immigrants a year into a country with a housing crisis has something to do with it? People are stretching their budgets on mortgages, yes, but it's coming to a point of necessity. The government isn't going to crater the housing market in their key city ridings, these people depend on their house value for retirement. At some point something is going to give. No one will have enough income and free cash to purchase these overpriced bubble houses from boomers who are depending on that home value to retire. That time is coming.
 
Just remember a average home at the moment is 731k. Your top 1% earner in this country cannot afford to buy a average home with a 5% downpayment.

If you only make minimum mortgage payments the 25 year length of a mortgage it doubles in cost. So that 731k house really cost you 1.462m.

With my salary which is well above average if I work until I am 65 I will have only made about 1.6-2m after taxes (todays money). Are we supposed to live on 600k for everything else in life?

It is extremely expensive to build new houses. There is a lack of building yet a massive influx in people living in this country. We just passed 40 million the other day.

Couple in companies buying up tons of properties as ‘investments’, foreigners who don’t live here buying up houses, the influx of illegal funds to buy property, and the weak controls in place to prevent a market collapse and it isn’t a good sign.

There are American investors starting to short our banks because they know CMHC is running out of funds for when people default and the banks themselves do not have the funds available to deal with a housing collapse.

We are in for a rough ride when it all comes crashing down.
 
So, we have the second highest per capita health care costs in the world (behind the US), with some of the worst outcomes/wait times in the OECD.

When do you suppose the dream of a single payer health care is going to pay off?
Right, we may be be at the bottom of OECD countries, but we are far ahead of the US, and of all those OECD countires, which one doesn't have single-payer health care? Oh right, the US.

So, while it's unfortunate that we are in last place, that doesn't mean we should get rid of our system and adopt the American one. That looks like a recipe to just make things worse. That'd be like being in last place in a bicycle race and then saying "This isn't working; I'm walking instead!".

Instead, we should look for reasons why we are lagging so far behind the other OECD countries and come up with solutions to our specific issues.
 
Right, we may be be at the bottom of OECD countries, but we are far ahead of the US, and of all those OECD countires, which one doesn't have single-payer health care? Oh right, the US.

So, while it's unfortunate that we are in last place, that doesn't mean we should get rid of our system and adopt the American one. That looks like a recipe to just make things worse. That'd be like being in last place in a bicycle race and then saying "This isn't working; I'm walking instead!".

Instead, we should look for reasons why we are lagging so far behind the other OECD countries and come up with solutions to our specific issues.

Perhaps the answer lays in a combination of the two ?
 
Just remember a average home at the moment is 731k. Your top 1% earner in this country cannot afford to buy a average home with a 5% downpayment.

If you only make minimum mortgage payments the 25 year length of a mortgage it doubles in cost. So that 731k house really cost you 1.462m.

With my salary which is well above average if I work until I am 65 I will have only made about 1.6-2m after taxes (todays money). Are we supposed to live on 600k for everything else in life?

It is extremely expensive to build new houses. There is a lack of building yet a massive influx in people living in this country. We just passed 40 million the other day.

Couple in companies buying up tons of properties as ‘investments’, foreigners who don’t live here buying up houses, the influx of illegal funds to buy property, and the weak controls in place to prevent a market collapse and it isn’t a good sign.

There are American investors starting to short our banks because they know CMHC is running out of funds for when people default and the banks themselves do not have the funds available to deal with a housing collapse.

We are in for a rough ride when it all comes crashing down.
We're standing on a precipice- but the crash is not inevitable. It's important to remember that the active housing market is not fully indicative of the average price paid, debt load etc for the entire population.

Focusing on Ontario, there's around 5.5 million dwelling units. Over the from 2020-2023 (when the bubble got really bad) there's been ~860k bought sold - some of them the same house multiple times. Even if you factor in risky/ aggressive HELOC usage and refinancings it's unlikely that the number of homes (and mortgages) on the books at present values is higher than 20%. There's room for a soft landing, but the factors you mention need to be addressed right now.
 
Perhaps the answer lays in a combination of the two ?
If the situation was right, I would actually agree with you and see this as at least a potential option.

However, right now we have a dirth of doctors and nurses in this country. If we allowed more private health care, where would those companies get their doctors and nurses from? They'd come from the public sector.

So, while a few rich ppl would get faster access to care, the situation would just become worse for every day Canadians.
 
If the situation was right, I would actually agree with you and see this as at least a potential option.

However, right now we have a dirth of doctors and nurses in this country. If we allowed more private health care, where would those companies get their doctors and nurses from? They'd come from the public sector.

So, while a few rich ppl would get faster access to care, the situation would just become worse for every day Canadians.

That's a very fair point.

What do you recommend ?
 
Perhaps the answer lays in a combination of the two ?
There are many OECD nations that make use of a hybrid system and produce better outcomes for less money than the US. We should absolutely be looking at reform, but the discussion needs to be completely re-framed and be focused on emulating those better systems rather than getting sucked into American ideological arguments.
 
There are many OECD nations that make use of a hybrid system and produce better outcomes for less money than the US. We should absolutely be looking at reform, but the discussion needs to be completely re-framed and be focused on emulating those better systems rather than getting sucked into American ideological arguments.

So yes, you agree then ? The answer is a combination of the two or a hybrid system as you state ?
 
The Scandinavian countries would disagree. Very high social services, very high taxes.

So, we have the second highest per capita health care costs in the world (behind the US), with some of the worst outcomes/wait times in the OECD.

When do you suppose the dream of a single payer health care is going to pay off?

Both valid points, that speak to productivity. Canada has of late had the cover pulled off its comparatively low (amongst G7, and more) productivity. Our federal public service had been bloating significantly (at least since 2015… 🤔) and productivity qualitatively appears to be heading in the opposite direction. If our public service productivity/performance were similar to the heavily-taxed Scandinavian countries, I’d have less of an issue with how much of my taxes go to service that sector.


However, right now we have a dirth of doctors and nurses in this country. If we allowed more private health care, where would those companies get their doctors and nurses from? They'd come from the public sector.

They’d more likely come from an increase in doctors staying in Canada, vice draining to the US, etc. because of factors such as capping health care remuneration (OHIP capping, etc. Family health practices are not as lucrative for practitioners as many folks would be led to believe). I’ve lost two family doctors since leaving the CAF, one who left private practice to return to specialization at a major hospital and the other who left to emigrate to the US).
 
That's a very fair point.

What do you recommend ?
Having little knowledge on how the medical system works as far as training, licensing etc I would start with maybe some basics.

Recognize foreign credentials and make the quals recognized between all provinces. This comes with the right processes to do so.

Create maybe a separate licensing system for public and private sector with a term of service required in the public sector before being able to go into private sector. The same could be done to give accreditation to foreign trained types with a length of service in the public sector.

Increase the seat counts at universities to increase capacity to pump out more medical professionals.

Alternatively, private sector professionals could have a number of hours they need to perform concurrently with private sector to stay current.

Incentivize remote work or increase responsibility to PAs and RNs and increase pay scales for those in remote areas.

Just a few ideas but not sure if something like that would be feasible.
 
Right, we may be be at the bottom of OECD countries, but we are far ahead of the US, and of all those OECD countires, which one doesn't have single-payer health care? Oh right, the US.

So, while it's unfortunate that we are in last place, that doesn't mean we should get rid of our system and adopt the American one. That looks like a recipe to just make things worse. That'd be like being in last place in a bicycle race and then saying "This isn't working; I'm walking instead!".

Instead, we should look for reasons why we are lagging so far behind the other OECD countries and come up with solutions to our specific issues.
I am not for or against private care. The US isn’t the only private healthcare country in the world though.


If you take a quick look at the list and type of healthcare systems by country a substantial amount of Europe runs on a mixture of private/public. These aren’t the pure public model we have all been told they have. France, Germany, Netherlands, etc. are a mix and they all provide excellent healthcare.

Private does not mean it has to look like the states, where they go wrong is allowing for profit health care.

I am by no means a expert, just that there is alternatives out there which work quite well. As to what system is best, beats me, just that our current system certainly can use some major improvements.
 
So yes, you agree then ? The answer is a combination of the two or a hybrid system as you state ?
It could be. Or it could be diving into what Taiwan does to make their single pay system so damn efficient and effective. As the rankings show, lots of countries can give us lessons on how to do things better. We should be taking a comprehensive approach to reviewing those better performing systems, learning the lessons, and implementing what we can- not arguing about how much more or less like the US we should be, because objectively the US is only in the discussion because of geographic and cultural proximity- not because its a rational reference point for healthcare improvement.

Hence re-framing the debate.
 
Increase the seat counts at universities to increase capacity to pump out more medical professionals.

I can't speak to any other points but this is being done. We've opened up a new intake for nursing students. The net result should be about 100 more grads per year. I know the Faculty of Medicine is working on this as well but is facing much higher regulatory pressure to make sure that the standards are not lowered.
 
I can't speak to any other points but this is being done. We've opened up a new intake for nursing students. The net result should be about 100 more grads per year. I know the Faculty of Medicine is working on this as well but is facing much higher regulatory pressure to make sure that the standards are not lowered.
Has the bar been continually raised over the years I wonder? Maybe the standard needs to be a little lower to generate more quantity.
 
Has the bar been continually raised over the years I wonder? Maybe the standard needs to be a little lower to generate more quantity.
Raised or unnecessarily high.

I remember when physio therapy went from a 4 year undergraduate program to an additional 2 year Masters.

Some countries have direct from high school graduation into med school. Not sure why that can’t work here.
 
Perhaps the answer lays in a combination of the two ?
There are many OECD nations that make use of a hybrid system and produce better outcomes for less money than the US. We should absolutely be looking at reform, but the discussion needs to be completely re-framed and be focused on emulating those better systems rather than getting sucked into American ideological arguments.

The first thing I do when comparing systems is realize that Canada is not the same as any of those other better performing OEDD countries. We are not the same in size; we are not the same in population density; we are not the same in political systems; we are not the same in social culture; we don't have the same history of providing medical services; and on and on. One benefit that the other countries have over us is that they are thankfully not joined at the hip with the USA.

Could we do better by adopting some of their processes? Of course. But the primary obstacle to that is politics. Or more specifically, politicking. The number one complaint about our system(s) of health services and health insurance (two different things) is cost. And to a politician, "cost" becomes a platform issue about reducing it or getting someone else to pay the freight. And of course, the attention span of a politician is the next election, not the 25 years (my estimate of how long it would take if I was emperor) necessary to make the changes to health and education systems as well as the cultural modification required to make it stick.

What should we be looking at in terms of hybrid systems (or even other single payer systems)? While my experience with other countries' systems is decades old (yes, I'm one of those dinosaurs who served in CFE - that's where I was when I did some of my university education in health management) and I'm more familiar with Germany, most of those systems require 100% participation by both employer and employee with the obvious government assistance to those with below adequate income levels (seniors et al). The two most important changes (in my opinion) have already been proposed; universal drug and dental coverage.
 
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