Tuesday, August 07, 2007

Private health care - a matter of life and death

Front page story in the Record today - Desperate search for care.

Catherine Cooke of Walkerton was diagnosed with cancer, and basically told that there was little or no hope.

Instead of waiting for death she opted to spend an inheritance from her mother on private health care in India.

The treatment is now close to being complete and the cancer is almost "non-existent."

Something tells me this family will not be very impressed when Health Minister George Smitherman tries to sell them on another McGuinty government in October.


* * * *
Too bad Catherine Cooke wasn't just looking for cricket money.

30 comments:

Moebius said...

As someone who supports choice in healthcare, I think a single example doesn't really do the debate justice.

What we need, in Canada, is to have a mature debate on how to improve the system, public, private-public mixed, or whatever. In our adversarial political systems, I'm not sure this can be doen.

The CPC minority will now fight any changes, because the Libs have defined them as destroyers of our beloved public system, and it would be political suicide to die on that sword.

This is really where a multi-party discussion towards improvements is required, with no political blackmail involved. I can only dream.

PGP said...

Well said Moebius!

However I believe that it can be done and done in the context of our Democratic political system!

The real impediment is the fear mongering of certain politicians and the acerbation of this in the public mind by MSM's failure to promote understanding or intelligent discussion.....

If you need an example look into the media coverage of the current head of the CMA and his position on the issue of creating options for medical care.
The usual suspects! They've made this into a turf war where every alternative or real solution to the incompetent and disfunctional state regulation and gatekeeping of medical service is made out to be an attack on some mythical RIGHT of the bureaucrats to hold sway over the public health.
Asking for honest and open discussion from people like this is like asking for rats to vomit! They can't.

BTW - This example of health care tourism is unfortunately not unique.
It is not even uncommon.

Anonymous said...

when faced with options people will take them.

It sounds like there's more to this story than meets the eye.

At least Walkerton has doctors and a CT Scanner, which is more than most towns of the same size in the rest of the province. Want a CT Scanner, raise taxes or fundraise.

McGuinty's really got to go.

Joanne - please PLEASE get the ball rolling and take a cue from Liberal Cherniak re elecion reform.

Do it NOW before the Liberals take advantage of voters not doing their homework.

Anonymous said...

moeblus is right! Harper's been defined on healthcare by the left and will let choice down because of it.

I actually think the John Tory on this issue is further right than Harper

SouthernOntarioan said...

I moved from my home town to another city in Ontario and I haven't had a family doc since.

Its so bad in many regions that docs now interview prospective patients (something that used to be the other way around).

Roy Eappen said...

Lawsuits in both Ontario and Alberta are being pursued to end the government monopoly on healthcare. Why should the govenment be able to stop you from saving your life?

liberal supporter said...

Why should the govenment be able to stop you from saving your life?

Yes, the bad old government. Note that they didn't stop her from doing anything. She did nothing illegal.

But of course around here, "choice" really means "no government funding". A free market in health care which is run by all the for-profit businesses that would be here in a flash. It means if we ever decide to have a public health system again we will face lawsuits under Nafta from them. Even a small public initiative can be litigated if it affects market share of one of the medicorps.

You worry about UofT closing its rifle range? How about the medical school? Yes, it is subsidized by the government, so its doctors are causing unfair competition to the medicorp industry's salaried doctors. I'm sure there would be a lot less fuss, because the UofT would simply be following the law.

The medicorps would be here now with a CPC majority. They're already prepared to come in and get established. Once established you can never go back.



Yes, our bad old health care system has to go. Instead of the government, we should let the almighty dollar stop me from saving my life. I don't have $41,000, so I guess I'd just have to suck it up and die.

I'm sure your private system would help keep the churches full though, with us poor folk praying for miracles. At least it would for straights like me. But suppose some woman gave me HIV? Would the churches still let me in to pray for my miracle? They'd think I was gay because of the disease.

I love being a right winger! It makes life nasty, brutish and short.

John M Reynolds said...

"Yes, our bad old health care system has to go." What are you talking about Liberal Supporter? Why are you arguing about getting rid of the public health care system when neither the original post nor its comments went so far as to suggest that? You are arguing an off topic idea. Your strawman argument is ridiculous. All people are asking for is choice within this country, so the health care tourism can end.

Anonymous said...

TangoJuliette sez:

Liberal supporter, and all Liberals for that matter, especially those who fashion themselves to be founding fathers of Medicare. I knew you flakes when you were against this, before you were for it after you claimed to have created it.

Your Liberal Gov't in Ottawa just ripped Wee Tommy non-stop. Called him a Communist and all.

go back and read what all it is that he exactly proposed.

It sure as hell wasn't what you were opposing in the sixties and it isn't what you oppose now.

Is that voice of the great Liberal brain-trust coming out of the back end of their trousers again?

what arrogant, partisan dorksters.


poot* and pffft!**

tj

Gabby in QC said...

"I love being a right winger! It makes life nasty, brutish and short."

With the wild scenarios you've painted, you may as well bring in the environmental angle as well:
a shorter life = a smaller carbon footprint ;-)
You're FOR that, right?

Roy Eappen said...

liberal supporter has completely missed the point. Right now people like Paul martin can use private resources to get himself an MRi or a doctor. Why shouldn't all Canadians have the right to buy insurance. It will shorten the waits on the public side as well.

Joanne (True Blue) said...

I'm not sure what the answer is, but it sure isn't what's happening now.

Jeff Davidson said...

i believe the current federal govt's health minister, formerly known as 2 tier tony, recently stated that the feds had NO intention of promoting/developing 2 tier health care....

John M Reynolds said...

That's okay Jeff. Health Minister George Smitherman mentioned in the post is provincial. This is the responsibility of the provinces anyway.

liberal supporter said...

Why are you arguing about getting rid of the public health care system when neither the original post nor its comments went so far as to suggest that?
Of course they don't. It's the hidden agenda, remember? Can't talk about it without a majority. The big HMO medicorps will just have to wait a bit longer.

You are arguing an off topic idea.
It is on topic. The topic is "Private health care - a matter of life and death". It certainly is. I would be dead in that woman's situation. With a more treatable condition, I would get treated in the current system, but I would still dead in your private health care utopia.

Your strawman argument is ridiculous.
Which argument is ridiculous?

All people are asking for is choice within this country, so the health care tourism can end.
You have choice. You just have to pay for it. The only difference in your private system is everyone is a customer instead of a patient. A lot more people will die or live with disease because they simply can't afford it.

Your private system does not give you more choice. It just makes some choices cheaper. And more people die.

What is the problem with health care tourism? You want all kinds of experimental procedures paid by the public health system? That would certainly make it easier to bankrupt it so that we would be forced to give it up. Then the medicorps can move in and establish their businesses. With Nafta rules, once private health care is established, the government can never have a public health system again.

Liberal supporter, and all Liberals for that matter, especially those who fashion themselves to be founding fathers of Medicare.
Now who's off topic? I care not who founded medicare. As I understand it, it came in during a minority government. A great achievement.

I had high hopes that this minority government might produce similar great results. But it has simply become Harper's Quest for majority. A majority that will see medicorps take our health system private, and we will never get it back again. Part of the no longer hidden agenda.

With the wild scenarios you've painted, you may as well bring in the environmental angle as well:
a shorter life = a smaller carbon footprint ;-)
You're FOR that, right?

Who's putting up straw man arguments now?

PGP said...

I repeat...

The usual suspects! They've made this into a turf war where every alternative or real solution to the incompetent and disfunctional state regulation and gatekeeping of medical service is made out to be an attack on some mythical RIGHT of the bureaucrats to hold sway over the public health.
Asking for honest and open discussion from people like this is like asking for rats to vomit! They can't.

Paul said...

Right now people like Paul martin can use private resources to get himself an MRi or a doctor.

Very true.

I'll say clearly for everyone here tonight: We have private health care in Canada.

And here's the real news flash...we've had it for years!

I live in Niagara Falls and I do pay for medical services. I have for years. This is nothing new. What can't do, is pay for an operation, which is the main fault of the current system.

I go to a private clinic for blood tests and other diagnostic services. I pay about $50 for each and I don't mind paying it. To be frank, I have the resources to do it so why should I force my way into the public line-up and make someone else who doesn't have the resources wait behind me?

If I ever got cancer (god forbid) I would want to do the same. If I can pay someone to do it why should I make someone wait behind me? If I remove myself from the public line-up, just as I do with my diagnostic testing, that means someone else gets in faster.

We don't have to accept a fully-private system, we can have a mixed system. The US has a horribly flawed system - I'll be the first to admit it. It doesn;t work. Neither Canada nor the US has the perfect formula yet.

SouthernOntarioan said...

Guess what country has been rated as having the best health care system in the world? France.. what system do they have? Two-tier, private-public mix.

Horrors, imagine that, the socialist state that is France still realizes that perhaps private-public mix is not the great evil that LS makes it out to be.

LS, no one could/would close down med schools. That argument is just silly. All universities get government subsidies for every program and people leave these publicly funded universities and get jobs in the private sector all the time.

You could get a Ph.D in Engineering from a publicly funded university and go and work for Chrysler (a private company). So why couldn't someone get a M.D from a publicly funded med school and go work the in the private sector?

So your argument about introducing private health care killing med schools is not based on logic.

Joanne (True Blue) said...

The Jeff Allan Show will be covering this story this morning after the 9:00 news. You can listen on-line.

Call in if you like!

John M Reynolds said...

LS, is it the Ontario Liberal party that has the hidden agenda? Or are the Alberta provincial Conservatives a part of it too?

The USA has both private and public health care. Their system is not perfect, but the point is that NAFTA will not be able to stop us. Health care tourism requires more cash for travel outside of the country. Nor can you get private health care insurance if you are going outside of the country. There are also many who cannot leave the country who would not qualify.

Moebius said...

A little over the top there, LS. Not really what I was hoping for as a mature debate.

When I talk about choice, I mean exactly that. Other countries manage to do it, with varying results. If I'm rich in Canada, I already can go to the US and pay for what I want, and still get the "free" care here as well.

The problem in Canada is that we can't even discuss how to do it better without the "right wing conspiracy" voices of doom arising. This is my main point, and you've already proven it true.

Moebius said...

pgp,

Rats can't vomit?

liberal supporter said...

The problem in Canada is that we can't even discuss how to do it better without the "right wing conspiracy" voices of doom arising. This is my main point, and you've already proven it true.

The problem in Canada is that we can't discuss what could happen, especially when various possibilities are more favoured by respective parties, without the voices arising that a) claim my opinion has no value because of what party I support, and b) call my words the voice of doom. You have just proven that.

My comments were based on the fact that the topic is "Private health care - a matter of life and death", not public-private or some mixed model. Private health care is the topic. My comment was specifically responding to a Doctor who said "Why should the govenment be able to stop you from saving your life?". When in fact the government is not stopping you.

Their system is not perfect, but the point is that NAFTA will not be able to stop us.
Nafta has many rules that allow litigious private companies to sue governments that compete in their turf. For example, the softwood dispute is over claims that Canada is subsidizing our exports. I think that has to do with the "stumpage fees" being deemed too low by the US. In other areas, Canada's health care system is touted as being essentially a subsidy. It seems when the US loses a case, they just impose duties anyway.

Health care tourism requires more cash for travel outside of the country.
So your main concern is the money. Great for those who can afford it.

Nor can you get private health care insurance if you are going outside of the country.
I assume you mistyped this, otherwise these people are asking you to break the law.

You could get a Ph.D in Engineering from a publicly funded university and go and work for Chrysler (a private company). So why couldn't someone get a M.D from a publicly funded med school and go work the in the private sector?
No problem with Chrysler, since the government does not have a car manufacturing business (shh don't let the dippers hear that).

But for government health care, it would be competing directly with private firms. If the private firms cannot attract staff because the government health system is not a capitation based system and is preferable for doctors, they will try to bring in outside doctors. Aside from relatively minor problems getting them fast track approved to practice here, such doctors have huge school debts and cannot afford to work at our rates. Therefore the medicorps will allege unfair subsidy and take the government to dispute resolution for subsidizing the supply of doctors.

My main point is these things can happen, especially as unintended consequences and if they do, undoing them is much more difficult. You can say they are unlikely, and we can argue about how likely, but a mature debate should avoid over the top statements talking about "the government stopping you from saving your life". You couldn't leave the country to save your life in the USSR. You can here.

Moebius said...

You're being disingenuous. This discussion has been, despite the title, about choice for Canadians, and you turned it into the standard anti-CPC rant. We'll hear enough of that in the next campaign.

If you want to narrow the discussion, that's up to you.

Tell me, are you completely or somewhat happy with the current system, and if not, what would you propose to improve it?

Joanne (True Blue) said...

This discussion has been, despite the title, about choice for Canadians

That's right. I can change the title if that's an issue. Suggestion are welcome.

The real issue is why do Canadians have to travel out of Canada to be treated? Why can't they get the necessary treatment here in a timely fashion?

A mix of public & private could very well be the answer.

Why not have the jobs here? Travel would be easier and more efficient. I don't even see why it's a question. And it's already happening in some areas anyway. It's inevitable.

Moebius said...

It doesn't even have to be public/private, but something creative is required. I read about a modified system (in BC?, I forget), that pays the ER more for moving people more quickly through treatment ($ for results), and then the hospital can use the money to hire more staff. I can see potential for abuses, but at least it's a new idea.

Who the heck knows? I know that the system cannot be improved when politicians are afraid of the fallout. Any discussion of changes will be used against them, with a simple theme: supporter of US style 2-tiered health care! I can see the TV ads now.

Private doctors in our streets? In Canada?

We seem to forget that dentists, opthamologists, and the like are also privately practicing doctors.

liberal supporter said...

you turned it into the standard anti-CPC rant.
Everything that is contrary to the party line is "anti-CPC". We're 26 comments in, it's about time for someone to call me "hateful" as well as "disingenuous". Funny, I just used "disingenuous" in a comment in the "other place".

This discussion has been, despite the title, about choice for Canadians
I won't even go there, it's too funny. Change the topic, so everyone is now off topic?

But the reason for reproducing that quote is it seems the discussion is more about more choice for some Canadians, while possibly decreasing it for others.

To answer your question, I would say "somewhat happy". Everything has room for improvement, and anything run by the government is always inefficient. But ditching universality is not something I would ever agree with.

From what I understand, the P3 projects do not really threaten universality. If they want to outsource construction and maintenance of a building, it sounds fine, though I would like to hear the arguments against it. From what I know, a P3 project is mostly about the capital and operating costs. Presumably it does not mean there will be guards at the entrance to make sure you have money or credit before you get treated. The only argument I could think of is that the private partner might have bigger cost overruns (including profits) that the government would have to cover. But such things should be dealt with in the agreements involved.

Let me try an analogy: The scenario that concerns me is akin to the disappearing phone booths. A parallel phone system was built on cell towers, and there has been a large shift to it. Not only are few new phone booths being built, but many are being torn down.

Those who cannot afford cell phones are now out of luck. The home telephone is considered essential, so the rate for basic service is regulated, but if you are not at home, you can no longer make a phone call in many public places.

For something like phone service, the withering first tier does not greatly concern me. Some people will just have to do without. Too bad.

For health care, the withering first tier would happen as well if there is lots of "choice". The results of this are sicker people which means less personal safety for me and everyone else.

So I am against any parallel system that leads to doctors abandoning the first tier in large enough numbers that it becomes unworkable.

There is plenty of room for improvement, and innovation is certainly needed.

liberal supporter said...

We seem to forget that dentists, opthamologists, and the like are also privately practicing doctors.
Dentists are covered by ohip if the work is "medically necessary", i.e. you are in a car crash and it knocks your teeth out.
Likewise ophthalmologists, if referred by your GP.

I can live with certain services being not covered. That is how we try to control the costs.

Agreed, the incentive system to keep things moving can work to a point. I recall reading about some country where you pay the doctor when you are healthy, then they don't get paid if you are sick. Again, it could work out badly, but it's a thought.

Moebius said...

Making health care work better is not a "party line". It should be a non-partisan issue. I'm not a CPC member, and have voted the Libs federally twice since '93. Had Martin been the same PM as he was Finance Minister, I might have voted for them again.

Not only has the current government not proposed the two-tier system (as promised), they are now afraid to make any substantive changes, because they fear the labelling.

I don't think all of these P3 projects are just outsourcing construction and maintenance of buildings. Doctors' are currently performing surguries, as long as they don't also work in the public system.

SouthernOntarioan said...

LS: Docs leaving the public system in droves won't happen.

Did you know that family doctors are required to spend x hours a week in the emergency room? Similar things can be set up with private doctors.

Doctors can spend x hours working in a private health care setting as long as they work y hours in the public system.

France doesn't have the best health care in the world for nothing...

And cutting back on services is the wrong way to go. Because again you are neglecting the poorest of the poor who can't afford most stuff like that.