2022 CPC Leadership Discussion: Et tu Redeux

[SeaKingTacco]

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.

Nice Strawman.

Where did I say we should adopt the American way ? Be specific.

If what we are doing is not working (and is acknowledged by just about everyone in Canada to not be working), but any time anyone outside the LPC suggests any change or experimentation that does not rigidly follow the model everyone agrees is failing, they are shouted down as “American privatizers”.

The LPC has held power since 2015. Surely, in 8 years, they could have worked with the Provinces to make things better, not worse, in that time.

Or is this just another one of those thing we are not allowed to blame on the Liberals?

 

[GR66]

And keep in mind that Health Care is constitutionally a Provincial responsibility. The Federal Government however uses the Canada Health Act to control the Federal tax dollars that go to the Provinces to help fund healthcare. The fight between the Provinces wanting to do their own solutions vs the Federal Government wanting to impose a "standard" level of care for all Canadians makes real structural changes to the system very difficult.

 

[Halifax Tar]

Nice Strawman.

Where did I say we should adopt the American way ? Be specific.

If what we are doing is not working (and is acknowledged by just about everyone in Canada to not be working), but any time anyone outside the LPC suggests any change or experimentation that does not rigidly follow the model everyone agrees is failing, they are shouted down as “American privatizers”.

The LPC has held power since 2015. Surely, in 8 years, they could have worked with the Provinces to make things better, not worse, in that time.

Or is this just another one of those thing we are not allowed to blame on the Liberals?

I think its more about PP not acting like a PM... You know, while he's sitting on the opposition's side of the rink...

 

[dimsum]

Need life and death care - ER - Yes gov provided. Need aftercare to see doctors for surgeries etc, get a job and get private insurance. I'm done with wasting my tax money on your obesity or cigarette related issues that do nothing but strain healthcare systems.

There is a very clear example to the south of us. You are describing the American system.

The side effect of that is what happens if the economy craps out and folks lose their job? They have no medical issues but all of a sudden have no healthcare, over something they have zero control over (like the 2008 GFC).

Or the other side effect - if you absolutely hate your job or are badly mistreated, you stick with your job for the medical care. Forget benefits - literally you would be bankrupt otherwise.

I don’t think that sounds like a great system at all.

 

[OldSolduer]

Need life and death care - ER - Yes gov provided. Need aftercare to see doctors for surgeries etc, get a job and get private insurance. I'm done with wasting my tax money on your obesity or cigarette related issues that do nothing but strain healthcare systems.

What happens - heaven forbid - when you get some affliction though? Will your private insurance cover that?

You're "holier than thou" attitude is becoming tiresome and counter productive.

 

[Halifax Tar]

What happens - heaven forbid - when you get some affliction though? Will your private insurance cover that?

You're "holier than thou" attitude is becoming tiresome and counter productive.

I think there needs to be some reexamination of how long and to what effect people can expect to draw benefits from a system they have contributed little to nothing into...

 

[suffolkowner]

We already have a hybrid system. Almost all of the system is private and the private or privatized parts are a big part of cost increases except for hospitals and administration.

Doctors-Private
Imaging-Private
Biological Testing-Private
Chiropractors-Private
Dentist-Private
Pharmacies-Private

We have something like 10 x per capita the administrators as Germany however. We have also completely constrained the supplies of doctors going through med school since Bob Rae at least, restrict their ability to move between provinces and put up huge barriers to foreign trained ones

 

[Quirky]

What happens - heaven forbid - when you get some affliction though? Will your private insurance cover that?

You're "holier than thou" attitude is becoming tiresome and counter productive.

People leeching off the system they don’t contribute into is getting tiresome.

 

[OldSolduer]

I think there needs to be some reexamination of how long and to what effect people can expect to draw benefits from a system they have contributed little to nothing into...

And to that I agree. If you emigrate here at age 65 and are entitled to our "free" health care then you are a freeloader.

There was a case about two years ago that CBSA wanted to deport an entire family because the six year old "might" be a burden to the health care system. The family actually owned and operated a business.

 

[Halifax Tar]

And to that I agree. If you emigrate here at age 65 and are entitled to our "free" health care then you are a freeloader.

There was a case about two years ago that CBSA wanted to deport an entire family because the six year old "might" be a burden to the health care system. The family actually owned and operated a business.

I agree, I want add that one need not only be an immigrant to be a freeloader. Canada is good at creating them too.

 

[OldSolduer]

I agree, I want add that one need not only be an immigrant to be a freeloader. Canada is good at creating them too.

LOL yes you are correct - 100 % of our "guests" are freeloaders. And we aren't changing them.

Mind you there are alot of "entitled" Canadians by birth that are freeloaders on the street.

 

[Brad Sallows]

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.

For this to be true, I'd expect the same model to work for everything, and that would hinge on large government agencies being more agile and competitive - meaning, in large part, more capable of ingesting large amounts of information, assessing it more quickly, and acting on it more quickly, in ways that achieve the desired effects with a minimum of side-effects - than private companies at pretty much everything.

 

[Brad Sallows]

A little late on this, but...

JT vs PP isn't the issue. The question is whether a LPC or LPC/NDP government, in aggregate, would be better than a CPC government, in aggregate.

Whether or not governments spend money or people spend money matters a great deal, because what matters is the velocity of money. For governments, the more times a dollar changes hands in a lawful transactions (meaning, mainly, not under the table), the more times it is subject to taxation.

People tend to spend more readily when they're spending on themselves and feel secure in spending the next dollar. Taxation is just a way of saying "we're going to spend this for you", which leaves the taxed person figuring out what has to be given up (assuming he doesn't have a cushion and can not go into any arbitrary amount of debt).

If you think the sum of your federal, provincial, and municipal finances are on a healthy track, just keep voting for more of the same.

All of the hypotheses about how something "public" might work out, including public health care spending, are not worth much (if anything at all) unless they are grounded in a highly accurate understanding of how the economic incentives work.

Profit is a really, really strong incentive to produce.

 

[Good2Golf]

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.

Worse than last place?

 

[mariomike]

Interesting chat comparing Canadian and US health-care systems.

Not to suggest one is better, or worse, than the other.

Just different.

Eg :

A bill for a three mile Northwell Health ambulance transfer from one Northwell Health hospital to another. $6,100.50 dollars.

In Ontario, they could send you via land or air ambulance from Kenora to Toronto, or Ottawa , or another province, or country, if medically necessary.
"On the house."

Then round-trip back to Kenora for "free", if medically necessary.

 

[Colin Parkinson]

There is a very clear example to the south of us. You are describing the American system.

The side effect of that is what happens if the economy craps out and folks lose their job? They have no medical issues but all of a sudden have no healthcare, over something they have zero control over (like the 2008 GFC).

Or the other side effect - if you absolutely hate your job or are badly mistreated, you stick with your job for the medical care. Forget benefits - literally you would be bankrupt otherwise.

I don’t think that sounds like a great system at all.

As I mentioned before, Malaysia seems to be able to run both a full public and private system. Their public system has many of the faults that ours do, but if you have money, then you also have options to get quicker treatment. It's time for Canada to grow up and start looking at Healthcare models that don't involve the US. We treat Healthcare like a religion and the only thing keeping us from being Americans. It's no wonder we can't fix it, when we can't have a logical conversation on the subject.

 

[dimsum]

As I mentioned before, Malaysia seems to be able to run both a full public and private system. Their public system has many of the faults that ours do, but if you have money, then you also have options to get quicker treatment. It's time for Canada to grow up and start looking at Healthcare models that don't involve the US. We treat Healthcare like a religion and the only thing keeping us from being Americans. It's no wonder we can't fix it, when we can't have a logical conversation on the subject.

Sure, but I was responding to just a private system in terms of non-emerg care.

As for how it's the only thing keeping us from being Americans, sadly the last few years have made me wonder if your highlighted line is on point. But, I can say the same about some other countries and how they aren't (but really not too far from) like the Americans.

 

[Lumber]

That's a very fair point.

What do you recommend ?

A couple of things, some of which the CPC is talking about which is one of the reasons I haven't completely written them off.

First and foremost, recognizing qualifications from abroad. It is far too hard for a foreign trained doctor to work here. I just found out that a girl I went to high-school with has decided to move her family to Australia because, after a year and a half of trying, she can't get her Canadian license to practice as a Doctor, despite the fact that she was educated in Australia. Don't even get me started on cross-province qualifications. Why we have multiple colleges vice one national one eludes me. Actually, it doesn't; they have their own little fiefdoms and they refuse to see that disappear.

Second, as has already been mentioned, increase throughput in universities, and I think "direct to Med school" is something we should look at. One issue I don't have an idea on though is throughput in hospitals. After graduating university, doctors need to complete a residency, and I've heard (anecdotally) that that is a bigger bottleneck than universities; there simply aren't enough spots in hospitals for residents (since they need to be chaperoned/trained by fully qualified doctors; it's essentially OJT).

Lastly, incentives. We are actually producing a lot of doctors, but everyone wants to be a surgeon because it's sexy. No one wants to be a GP or work in rural areas, so they leave the country to go be private doctors somewhere else. Create a real incentive program to encourage doctors to stay in Canada, especially wrt GPs and rural doctors.

 

[Lumber]

Nice Strawman.

Where did I say we should adopt the American way ? Be specific.

If what we are doing is not working (and is acknowledged by just about everyone in Canada to not be working), but any time anyone outside the LPC suggests any change or experimentation that does not rigidly follow the model everyone agrees is failing, they are shouted down as “American privatizers”.

The LPC has held power since 2015. Surely, in 8 years, they could have worked with the Provinces to make things better, not worse, in that time.

Or is this just another one of those thing we are not allowed to blame on the Liberals?

Ok, fair enough, you did NOT say that we should adopt the American way. In my defence, you can't come into the conversation deriding our place in the OECD, insinuating that the system is never going to work, mention the US, and not expect me to draw the conclusion that you think we might be better off under the US system.

 

[dimsum]

A couple of things, some of which the CPC is talking about which is one of the reasons I haven't completely written them off.

First and foremost, recognizing qualifications from abroad. It is far to hard for a foreign trained doctor to work here. I just found a girl I went to high-school with has decided to move her family to Australia because, after a year and a half of trying, she can't get her Canadian license to practice as a Doctor, despite the fact that she was educated in Australia. Don't even get me started on cross-province qualifications. Why we have multiple colleges vice one national one eludes me. Actually, it doesn't; they have their own little fiefdoms and they refuse to see that disappear.

I'm not exactly sure but isn't changing the provinces essentially an application? AFAIK Med schools, nursing schools, etc don't say "your degree only works in AB" or something like that. However, having multiple colleges does create issues like how PAs, LPNs, etc are employed (or not).

Second, as has already been mentioned, increase throughput in universities, and I think "direct to Med school" is something we should look it.

Australia has "direct to Med School" and "direct to Law School". From a quick perusal online, it shortens the timeframe by about 1-2 years (med school in Oz is 5-6 years, plus 1 year residency). I would assume that the cutoffs for high school students are at least as stringent as those for the post-undergrad route. I'm guessing the issue is the number of spots in said medical schools, and short of creating more (in which case you need more profs, training hospitals, etc) I'm not sure whether allowing folks to apply from HS is the answer.

One issue I don't have an idea on though is throughput in hospitals. After graduating university, doctors need to complete a residency, and I've heard (anecdotally) that that is a bigger bottleneck than universities; there simply aren't enough spots in hospitals for residents (since they need to be chaperoned/trained by fully qualified doctors; it's essentially OJT).

As above.

Lastly, incentives. We are actually producing a lot of doctors, but everyone wants to be a surgeon because it's sexy. No one wants to be a GP or work in rural areas, so they leave the country to go be private doctors somewhere else. Create a real incentive program to encourage doctors to stay in Canada, especially wrt GPs and rural doctors.

Absolutely.