Sunday, March 9, 2008

Ontario medicare-monopoly 'riding on reputation', needs rebuild

Here is a chain of letters that developed in Niagara This Week, which began (I'll call it letter #1) with Mike Williscraft’s column, “Health care system in need of trip to E.R.”, (Feb.1, 2008).

Williscraft wrote: “I had a conversation this week with a distraught Niagara resident shocked and dismayed at what she now believes is a seriously broken health care system.
In this instance, the woman referred to a circumstance which took place Tuesday evening. She waited for four hours to get a bed in a common room -- four patients -- with a 102 F-plus temperature. Complicating things for this multiple sclerosis sufferer is her azathioprine prescription, which is an immunosuppressant.
Long story short, after having her bed for about a half-hour, she asked to go to the washroom. She estimates she was gone three minutes.
Upon her return, the nurse informed her the doctor had finally come by when she was gone and, not only did she miss the doctor, but her bed had been given away and she would have to go back to the waiting room. Yikes!
Now, don't get me wrong, this is a sad and unfortunate circumstance, and it happens all too often. If you ask three people, one will know of such a story. I know I do.
Back in 2000, seven years ago tomorrow. I was a few hours from being a statistic ... when I required an emergency appendectomy.
Right off the top, I want to make it clear my situation was no more sensational than hundreds of those which Ontarians have been exposed to in recent years as our once-proud health system has crumbled into a shell of its former self.
My ordeal started with a trip to West Lincoln Memorial Hospital's E.R. at about 11:30 a.m. There was no surgeon in that day, so I had to wait for a transfer to McMaster in Hamilton. By that point, if I you will allow, I can describe my pain situation as being 10 times worse than when I jumped a fence, landed in a rabbit hole, snapping my ankle. I also need to point out, the staffs at both facilities were first-rate. They are simply mired in a system that is failing.
I was told the ambulance would be 30 minutes, I hoped for an hour. Ninety minutes came and went. A nurse called -- 45 more minutes. Soon it was about 2 p.m. The left side of my stomach puffed and was very warm, almost hot. It wasn't a good thing.
Thirty more minutes passed. Another car trip is planned. As I am shuffling to the door, the attendants finally show up. Now, I assumed an ambulance would have a state-of-the-art shock system for delicate procedures en route. It was like riding in a horse and carriage -- brutal to say the least. That was the most pain of the whole ordeal.
Anyway, I get to Mac's E.R. and actually got a side room, while many, many others waited on stretchers in the hall. It was about 4:45 p.m. I saw my surgeon around 7 p.m., with surgery set for 10. I headed into the OR at 11:15 p.m..
After awakening, I was then transported to my room -- a STORAGE room on the 4th Floor.
The staff was, again, great -- constantly apologizing for something they had no control over as they flipped on the lights to search for gauze or whatever all through the night. What they didn't realize was I would have taken a parking spot next to the garbage bin for a solution to the pain.
The following day, just after lunch, my wife rode up in an elevator with a woman whose father had arrived in ER before me. He was still there.
As my caller noted, the system is riding on reputation these days. It is clearly in need of a rebuild. The staff can only do so much.”

In response to Williscraft, Richard Murri wrote (let’s call this letter#2) in “Can't use a snapshot to judge the entire system”, (Niagara This Week, Feb.15, 2008):

"Re: “Health-care system in need of trip to E.R.” by Mike Williscraft (Feb. 1)
I fully agree that certain parts of our health-care system are in need of major repair.
Since the days of Harris/Eves, the system has had to undergo an onslaught of funding cuts, reorganizations, mergers, etc., while the region saw a growth in population and an aging population.
Anecdotal evidence such as that of the poor woman in the article and of Mr. Williscraft in 2000 is, unfortunately, true. However, I can also cite experiences which were positive.
I have not had a family doctor since 2001, using walk-in clinics when necessary.
While this is admittedly not ideal, I have found the experience a mostly positive one.
Two years ago, I too experienced an appendix attack. Upon arriving at St. Catharines General (from Niagara Falls), I was seen by a doctor in emergency within 20 minutes, placed in a bed within two hours and an appendectomy was performed the next morning (a Sunday).
I was home recuperating two days later.
My point is, looking at the situation at any given point in time is not an honest look at the problem.
There is a push on at the moment to go to an Americanized system of delivery of health services, allowing those with the means to obtain services before those without insurance or financial means.
If I had the answer, I would be nominated for the Nobel prize.
I do not. I do know, however that articles such as this serve only to give ammunition to HMOs and certain politicians who would love to grab a share of the health care funding pie in Ontario.”

In response to Murri, and in support of Williscraft, I wrote (letter #3) in “Light needs to be shone on ailing health-care system” (Niagara This Week, Feb.29, 2008):

“Unlike writer Richard Murri in his Feb.15, ('Can’t use snapshot to judge entire sytem") I commend columnist Mike Williscraft’s attempt (Feb.1, 2008) to bring Ontario’s failing health-care system to the discussion forefront, because it sure wasn’t debated during Ontario's recent provincial election.

We need more discussion, not less; we need to realize that these instances of the health-system failing patients are systemic, not dismissively anecdotal and unimportant. How many anecdotes do we need to hear? There is even a constitutional health-care challenge now before the Ontario court!

Where do HMO’s exist in Ontario? It would be great to have that choice. What are the names of these "certain politicians" who Murri claims “would love to grab a slice of the health care funding pie” (whatever that means)? In the last five years, for example, I have heard no Ontario politician or party having the guts to openly challenge our failing health-care monopoly.

The only politicians grabbing Ontario’s entire health-care-monopoly funding pie are Dalton McGuinty's Liberals, who, while blaming others, have themselves created a two-tier system by delisting health-coverage while concurrently creating a new multi-billion-dollar Health Tax.

Let’s not forget that when then-Liberal Finance Minister Greg Sorbara stood to introduce his hated Health Tax in the Legislature on May 18, 2004, Sorbara noted in his budget speech that: "For the past five years, health care budgets in Ontario have grown by an average of 8% per year."

That's right: the Liberals actually complained that for five years the Conservatives spent too much on health-care, and so the Liberals were now going to "control " that! “To improve” health-care, Sorbara said , his Liberals had “to delist” previously-covered health-care!

We need to know that the health-care climate in Ontario is not all settled. We need to reduce the politicians' health-care-policy footprint which restricts our individual health-care choices. We need to see that the Liberal’s Commitment To The Future of Medicare Act is a policy failure. We need to understand that 'universal health-care' is not the same as 'government monopoly health-care'.

And we should also acknowledge and give a note of thanks to the maligned American system which is treating so many Ontarians who have been let down by the McGuinty Liberals.”

I supported Williscraft writing about health-care issues in Ontario: unlike Murri, who condemned him, I commended Williscraft. I clearly pointed out my conviction that we need less government and political intervention in our health system.

Richard Murri’s next letter was indeed interesting, if not outlandish. In (letter #4) “Health-care debate can't be driven by politics”, (Niagara This Week, Mar.7, 2008) Murri wrote:

“I am reluctant to respond to the attack on my letter to the editor of Feb. 15 regarding the health-care system and its apparent shortcomings, however, I cannot allow the statements made and the questions posed by Mr. Bobak to go unanswered.
First of all, I agree that more discussion on this important matter is needed.
The discussion, however, must be informed and factual, not driven by political affiliation or ideological beliefs. Holding up the "maligned" American health system as an example to be copied is ludicrous.
Statements such as, "We need to reduce the politician's health-care policy footprint which restricts our individual health-care choices" and "We need to see that the Liberal's Commitment To The Future of Medicare Act is a failure," are taken directly from the Tory hymn book and hardly raises the level of debate.
I am not a member of any political party and my letter was not a blanket defence of the Liberal Government's handling of the health care file. Mr. Bobak asked for the "names of certain politicians" who wish to increase private medical services. I will give him one: our current Prime Minister, Steven Harper.
Harper has been (and still is) one of medicare's most powerful opponents, but as PM won't publicly state it. He spent years heading the National Citizen's Coalition, set up in the early 1960s with the sole purpose of stopping Saskatchewan from establishing public health care. The attempt failed, but this group, under Harper, never stopped trying to undermine it.
Now as a prime minister waiting for a majority in Parliament, he can do a lot more, mainly by refusing to enforce the Canada Health Act thus allowing more privatization.
Universal health care may not be the same as government monopoly health care and, Mr. Bobak, I didn't say that HMOs exist in Ontario.
I cannot believe, however, that you honestly think no private interests are seeking to profit from our health-care system.”

This is from a person who in letter #2 was complaining that Williscraft's column about health care could “give ammunition to HMOs and certain politicians who would love to grab a share of the health care funding pie in Ontario.” Talk about smugly censoring the level of debate!
By all means, Mr.Murri, let’s censor writers, such as Williscraft, because their writing might inspire changes which you don’t approve! Get flicking real, as Laurel Broten might say! Mr. Murri, you don't believe your own Marxist pablum, do you? The health-care pendulum has tilted too far, for too long, in favour of the anti-profit fear mongerers.

In a near-paranoid statement Murri claims my letter was an “attack”…whoa…easy, there, big fella. That letter answering Williscraft’s concerns, along with yours, in a newpaper, was a “response’, not an attack.

Maybe Murri is used to listening only to the sound of his own voice as he sings his hymns to a mirror. After all the frothy letters Murri has penned over the years (many against the Conservatives) Mr. Murri considers my modest letter an “attack’??!!

Mr. Murri, spare us your ancient crap about Saskatchewan and its socialized health care disaster. Even Janice McKinnon, Saskatchewan's former NDP finance minister, wrote (National Post, July 14, 2004):

"Change is necessary, and I believe that if Canadians open their minds to real change we can preserve the basic principles and goals of the medicare system that was designed 40 years ago. But accepting bold change will require courage and vision.

One of the greatest threats to medicare is posed by those who cling tenaciously to the status quo and claim they are defending Tommy Douglas's vision of medicare by doing so. That was never part of his plan.

Too often in politics, what we cherish most we inadvertently destroy by believing that protecting something means freezing it in time, when in fact protecting it may require dramatic change. Protecting children, for instance, means encouraging them to grow and adapt to the world in which they have to live. If we are going to save Canada's health care system, we will have to change it, and the sooner we embark on the road to change the smoother the journey will be."

How about that I ask Murri to apologize for misrepresenting what I wrote?

Murri wrote in his letter #4 that “Holding up the "maligned" American health system as an example to be copied is ludicrous.” Yet, I never wrote that we copy the U.S. system. Murri just imagined it, like he ludicrously imagines he knows what Stephen Harper will do in the future (and so, Murri possibly also knows next week’s winning lottery numbers as well?)..I've read about such tactics of innuendo and fear in books like Jonah Goldberg's Liberal Fascism, but find it incredible to be actually personally smeared by such tactics. Murri just made up what his biases led him to believe. Thanking the Americans for having the capacity and being able to help Ontarians who have been failed by the Dalton McGuinty Liberals is not ‘copying’ their system, Dick. You might pause to wonder, though, why the sicko Ontario system failed, and where (and why) Ontario’s sicko medicare monopoly was forced to send its patients. And you might wonder whose system failed these patients. C’mon, Dick: is it that hard for you to say thanks to our U.S. neighbours; to acknowledge that the American health-care system was there when Ontario’s promises of medicare weren’t?

Mr. Murri, the Canada Health Act needs serious revision, if not a total re-write. The fact is, your innuendo about Harper and the CHA is not factual - the minority Conservative government is maintaining the status-quo. It, along with McGuinty's Commitment to the Future of Medicare act, should be totally reformulated.

It’s the Ontario Liberal government's policies which are at the forefront of the problems we currently experience. By the way, maybe you should acknowledge, while you pursue your obvious anti-Conservative agenda, that Liberal Jean Chretien, for a dozen years, did nothing as the Canada Health Act crumbled under his THREE TERM MAJORITY GOVERNMENT. In the dozens upon dozens of letters you have written to various newspapers over your illustrious career, did you once ever mention anything about Chretien “refusing to enforce the Canada Health Act thus allowing more privatization” ?

And speaking of facts, Mr. Murri, you wrote of “HMO’s” (in your letter #2) as if they actually had some bearing on Ontario. So I had asked in letter #3 where these HMO’s were in Ontario? To which you wrote in letter #4 : “I didn't say that HMOs exist in Ontario”. Yeah: exactly…but you brought them up, in a fear mongering paranoid gambit as if they were relevant in Ontario, as if no one was going to ask you where they actually existed! Well, if they don’t exist in Ontario, why create false alarms??

And there was no answer from Murri regarding these plural “certain politicians who would love to grab a share of the health care funding pie in Ontario.” The best Murri could do when challenged on that was bring up his favourite dear old boogey man, Stephen Harper. Murri could find no politicians of any stripe in Ontario challenging our failing health system - which was exactly my point, and I believe was the whole point of Williscraft’s original column; this is the point we need to keep track of, and not be distracted by knee-jerk reactionary authoritarians like Murri who bring little to the discussion but their own dated ideological biases: Where are the Ontario politicians who are willing to face today's health care challenges? It should be obvious that Liberal Health Minister George Smitherman and his crappy diaper-load of failed statist policies aren't meeting the challenge.

When Murri writes of supposed politicians (who he can’t name) “who would love to grab a share of the health care funding pie in Ontario”, again, what is he talking about? In Ontario, the Liberals have a majority government; they have had it since 2003; they have collected billions of dollars of new health taxes, over and above the billions more they collected from already-existing taxation; and their health-monopoly is not demonstrably improving. The "health care pie" (ie, our taxes) is all appropriated by the provincial Liberal government, and given to its health monopoly. Murri claims he doesn’t have any answers in regards to health care, but sure could win a Nobel prize for casting red-herrings, and he conveniently doesn’t acknowledge the central role of the Liberal health care monopoly as having anything to do with the system’s problems. [What...there's a socialist elephant in the room? Where?! I can't see it...]

Searching for some common ground, I was encouraged that Murri agreed in letter #4 (oh...I might have inadvertantly 'attacked' him again...he did agree on my point, did he not?) when he wrote that "universal health care may not be the same as government monopoly health care." There may be hope once Murri digests what that means and substitutes 'may' for 'is', because this is the fundamental, underlying narrative of my position: that the currently-accepted notion of government-only, single-payer, monopoly health-care as the only method of health-care delivery, is a charade. This is precisely what the current Lindsay McCreith and Shona Holmes health-care Charter court challenges against the Ontario government are all about.

I think also that we should reconsider portraying Ontario’s continual examples of individual health-care problems by dismissively referring to them as “anecdotal”, rather than acknowledging that they’re systemic.

Shedding crocodile tears just doesn’t cut it. That’s a cruel, almost sadistic, response to the real patients failed by our health system: ‘Oops, you suffered…so sorry, old bean…you know, we meant to help you, we even virtually promised to help you, we taxed you for years in anticipation of helping you, you probably thought and even expected us to actually help you when you needed help…but, oops! these things happen…c’est la vie…you can’t expect us to be perfect, or to be literally held accountable, can you?...hey, now, stop your complaining…you are Canadian aren’t you…so get in line and wait…or go to the States…we don’t need your kind here then, anyway’. Really, eh?

I believe there should be less political interference in health care, and have written about this from various perspectives on numerous occasions. I even found Niagara This Week’s caption on Murri’s letter #4 - “Health-care debate can't be driven by politics”, frankly confusing. If anything, Murri demonstrates he is actually in favour of more political interference, not less! Or, maybe, Murri is not in favour of debate, UNLESS the debate is driven by his kind of politics?

The latter seems to me to be applicable. After all, Murri’s initial complaint about Williscraft’s original letter was that it might lead to alarming changes, vaguely involving Stephen Harper and HMO's which do not exist in Ontario, which displease Murri.

By his own definition then, Murri himself actually ‘attacked’ Williscraft by responding to him.

I say, Right On, Mr. Williscraft, and Write On!

Don’t let politically-correct ludicrous censorship deter you.

By the way, here is another story fittingly dealing with the subjects of both writing letters to the editor and poor Ontario health care:

Stephen and Catherine Collins wrote in “Frustrated with health-care”, (Barrie Advance, Mar.3, 2008):

“On Feb. 27 my husband and I sat for five and-a-half hours in Royal Victoria Hospital (RVH) waiting to see if we would win the ICU lottery.

My husband was scheduled for abdominal aortic aneurysm surgery, but would only receive surgery if enough ICU beds were available. We did not win the lottery, for the second time, his surgery was cancelled because of a lack of beds. If this has happened to us, I’m sure it is a common occurrence for thousands of Canadians every day.

Tommy Douglas must be rolling over in his grave.

Someone recently told me if a mere 10 per cent of people complained to their MPs, MPPs and newspapers, things would get changed when there is a problem such as this. Sit on your hands and say nothing, and watch our health care go down the crapper. Complacency will only get us more and more medical procedures health care will not pay for.

The government had already taken away eye exams. I guess the government thinks it’s cheaper to take care of the blind than prevent blindness. People who can not afford $100 for the exam could get macular degeneration and glaucoma.

Did you know there is a definitive test for cervical cancer, $90, but our plan will only cover a Pap smear (a crap shoot at best) which is only 55-per-cent accurate. There is also a definitive test for prostate cancer costing approximately $30. Again, this is not covered. Guess it must be cheaper for health care to pay for chemotherapy and radiation.

To this frustrated Canadian, this kind of thinking is penny-wise and pound-foolish. We deserve better. The pen is mightier than the sword, so fellow Canadians, dust off your pens and make our politicians accountable.”

Oh, oh… hope Richard Murri doesn’t complain to shut them up, too. Perhaps Liberal MPP Kim Craitor of Niagara Falls, or Liberal MPP Jim Bradley of St. Catharines, can publicly answer some of the Collins' concerns. We pay incredibly high taxes, while the Liberals raised billions in new Health taxes and cut coverage to supposedly-universal medicare. We have no legal choice but to take whatever the Ontario Liberals deem fit for us receive, yet the Liberals remain unaccountable.

Why aren't more people writing about this?

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