Thursday, March 02, 2006

Healthcare

I have been avoiding this issue for a while, simply because I am not an expert in healthcare. However, this is a hot issue in Canada right now and this is a good opportunity to start a conversation on it.

First, a few facts about Canadian Healthcare System:

- It is "universal" according Canada Health Act, meaning that essential healthcare (doctor's visits, surgeries and hospitalization) is funded by tax payers.

- We have a shortage of doctors and nurses, although we have a large immigrant community that has the expertise but doesn't have easy access to licensing (lobbying power of the physicians association).

-Wait times in emergency rooms are such that some heart patients die before they receive care. Getting an appointment with a specialist could take several months and some surgeries require a few years of waiting time (e.g. hip replacement).

- Provinces such as Alberta and Quebec (which usually dance to their own music) have recently started allowing private healthcare. This has caused a storm all over the country over this issue.


Margaret Wente of the Globe and Mail, who recently went through hip replacement writes: "Switzerland, which is a small country, doesn't have any central management at all. Health services are all managed locally, and and they seem to work quite well. What I do know is that management by mid-level provincial government bureaucrats — which is essentially the system we have now — makes it almost impossible to innovate or be flexible on the local level. Even obviously sensible changes are very hard to implement."

Questions:

- Would a private healthcare system shorten our wait-times? Or the shortage of healthcare workers? How and to what extent?

- Are we paying too much taxes and not receiving enough care? Would it cost us less if we had private insurance like the U.S.?

- Would a combination of private-public healthcare be best? e.g. Every doctor has to have X% of public service hours minimum and the rest private? How would hospitals function? Or clinics?

Generally, in a publicly funded system, a good portion of funding goes into administration. The larger the system, the bigger is the administration cost. However, would the addition of private clinics and hospitals reduce our taxes? If not, this just means that we will be paying for a fully public system that we won't use! Perhaps it's time we consider a locally managed healthcare (provincial?) instead of insisting on privatization?

I'd like to know what you have to say.

11 Comments:

At 11:49 AM, Blogger Bahar said...

Whoever visits this page and doesn't comment is chicken!

 
At 11:49 AM, Blogger Bahar said...

chicki chicki chicki....
ha ha ha :D

 
At 12:26 PM, Blogger Jackal said...

yeah, you're kinda right... what's happened to your loyal readers and their nice comments? where have they gone?

 
At 12:55 PM, Blogger Sooski said...

yes, yes, and yes. we should use Germany, France, and Finland as our model for public health care!
--s

 
At 1:03 PM, Blogger Bahar said...

Sooski joon,
I was getting worried! Gotta find more time for writing.

Jackal joon,
What's up? Did you get the job in Aberdeen?

 
At 1:17 PM, Blogger Jackal said...

I got back to London on Wednesday actually. I think the interview went really well though they moaned a bit about the payment!!!

There were two Norwegians and a Canadaian in the panel and I got introduced to the office at the end. The Norwegians were very nice and polite. I may even start playing golf with my bosses [;)]

I'm still waiting to see if I'll be offered the job or not - may take some time.

I'll have to write something about the health care policies in the UK and how ineffective they are!

 
At 1:24 PM, Blogger Jackal said...

and to Sooski: the health care system is not so easy a problem to solve by just adopting methods from certain european countries.

Germany and France are now experiencing the backlash of their social security and health care policies on their economies. They have the lowest rates of growth, suffering from static industry/market and huge unemployment. You can't solve a problem by pouring public money into it and expect to not see the consequences elsewhere.

 
At 1:35 PM, Blogger Bahar said...

Also:

Our biggest problem is that we don't know what to do with our "federalism". We are a nation of 30 million spread over a very large piece of this continent. We have native people, French, West-coasters, East-coasters and everyone has a different opinion.

Should we try to operate this big machine centrally? Or should adopt a more local agenda? Like education? Like the environment?

 
At 1:36 PM, Blogger Jackal said...

In many ways I think I understand Sky's concerns.

In the UK, the health care system has got the same shortcomings and problems that Sky mentioned for Canada.

Although private health care and private health insurances both do exist, the public health care system here is badly overstretched and massively criticised.

Solutions aren't easy to find. As Sky said, many people end up paying health insurance all their life but when it comes to useing the system, the quality is so appaling that they tend to refer to private services and pay for it.

Last year, Tories suggested that government could subsidise up to 50% of people's health care expenses if they opted to go private.

Do you think that's a good idea?

 
At 1:58 PM, Blogger Bahar said...

Unfortunately we seem to be following UK's footsteps!!!

Now we are 100% public. Tories will introduce private healthcare on the side. Then you pay health tax and pay for private service!!!

If we decentrilize the healthcare system, and give private clinics very limited authority, could perhaps get somewhere.

We are already paying too much for what we are not getting!

 
At 2:23 PM, Blogger Jackal said...

Just as you say, the service is not good value for our money. Here, a large portion of the available funds to the system are wasted the administrative and managerial departments rather than being diverted to the people. Red tape is a major problem here specially in the labour government. It is absurd that some finance managers in the White Hall (government building in London) who have no idea about the health care, medical staff and more importantly the patients, are resposible for policy making in the health service.

Decentralization / giving power to the local authoroities is probably the best way to manage this problem. I think that it is being done to some extent in Scotland.

Did you know that Scotland has got completely independant, judiciary, education, health care and banking systems? and they are praised for being vastly superior to England. They even have two more "bank holidays" [:D]

 

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