Tuesday, April 7, 2009

Canada does not have the best health care system in the world

Keith Martin wrote in "Europe's answer to our health care problem", (National Post, Apr. 7, 2009):

"Contrary to public opinion, Canada does not have “the best health care system in the world.” We actually rank 26th, and yet have the fifth-highest expenditures for health care. So, which countries fare better than us, and why? The Canadian Medical Association (CMA) just examined this question and came up with some fascinating findings.

Of the world’s top 20 national health care systems, 17 are European. These word leaders share some common traits: They all have mixed systems that combine both public and private providers; everyone is covered; no one is hurt financially when they fall ill; and there is the widespread use of information technology, which improves efficiency and reduces errors and cost.

In some European countries, prescriptions are no longer written — rather, all prescribed courses of treatment are entered into a computerized database which ensures less drug abuse, fewer administrative errors and greater oversight and transparency. Also, the efficient integration of public and private services has actually drawn on the strengths of both systems to ensure that patients get the care they need without being hurt financially. This has enabled countries to even expand coverage to include global prescription drug coverage.

The CMA found that in Europe patients are placed at the centre of the health care system. European hospitals are not paid solely by block funding — i.e., a lump sum of money that does not take into account the demands made of them. Instead, hospitals receive monies for services rendered. The medical system therefore treats patients as an asset, because resources are provided for treating each person. These efficiencies free up monies for prevention, health promotion and other initiatives that reduce the demand on our health care system.

When Europeans hear that Canadians tolerate atrocious waiting lists of nine to twelve months or more for care, and endure the pain, suffering and loss of function that accompanies these wait times, they are shocked. If they were confronted with these delays in Europe, people would be storming government offices.

Unfortunately, since the debate around health care reform remains mired in the false assumption that changes to our current system would result in a “U.S.-style system,” policy-makers stick their heads in the sand hoping no one will notice. Sadly, this inaction is contributing to the continued decline in access to care and the avoidable suffering that is the price the ill pay. Canadians must fully grasp the following truths:

• Demographic pressures brought on by an ageing population, and more expensive technologies, are outstripping the supply of money that governments have to pay for health care. This structural shortfall will certainly be exacerbated by the current global economic downturn.

• The Canada Health Act, and its five principles that govern health care in Canada (public administration, comprehensiveness, universality, portability and accessibility), is broken in every province, every day.

• We actually have a mixed system, but it is not integrated in a way that supports our public system.

• The status quo is actually contributing to the creeping privatization of our public system and a decline in the services that are covered.

The lesson we should learn from the Europeans is that the absence of competition leads to inefficiencies in our health system, a dearth of innovation and compromised care.

If we fail to modernize our health care system and live with the illusion that we have the “best” system, more and more people, particularly those of modest means, will fail to receive the care they need. This would be a national disgrace — and an entirely avoidable one at that. We can have the best health care system in the world, but we must adopt those solutions that will allow us to achieve this noble goal. We must have courage and we must not fear change."


Of course, St. Catharines MPP (and Liberal health care monopolist) Jim Bradley knows all about Keith Martin's views - because two and a half years ago, on Sept. 20, 2006, I had written to Bradley asking him then to respond to his federal Liberal cousin MP's views.

I asked Jim Bradley to comment on Keith Martin's article "Four ways to fix health care" (National Post, Sept.16, 2006), as well as John Turley Ewart's article "Where's the debate on medicare?" (National Post, Sept.9, 2006).

I asked Good Ole Jim to comment on the St. Catharines Standard's Aug.26, 2006 editorial, "Finding sustainable health care solutions", as well as John Carpay's article, "Chaoulli comes to Alberta", (National Post, Sept.19, 2006).

I brought to MPP Bradley's attention my letter, "Consumers have a right to choice in health care", (St. Catharines Standard, Sept. 6, 2006) - but our smug Liberal, Jim Bradley, couldn't give a flicking whit about what Martin, or anyone else, wrote. Bradley, our local Niagara single-payer-state-run-health-care-monopoly-inflicting-ideologue, simply hid - and still does - from explaining what his government is doing.

When Martin writes of those "who stick their heads in the sand", who immediately squawk about "American style two tier" whenever Ontario health care reform is mentioned, the definitive poster-boy for this Liberal tactic was none other than Niagara's knee-jerk obstructionist, Ole Liberal MPP Jim Bradley!

Oh, how Ole Liberal Jimmy huffed and puffed with his innuendo-laden, ominous, "slippery-slope" indignance; oh, how (with the ludicrous George Smitherman) he helped defend Ontario health-care's Liberal chastity from the evil clutches of an invading Cleveland diagnostic clinic! (see: Liberal Healthcare Duplicity, page 44-45)

Though they were writing on a different subject, Charles Lammam and Niels Veldhuis (in "Time to privatize", National Post, Apr.3, 2009) succinctly touched upon the very same concerns that Martin and others are raising, that being the inefficiency of state-run monopolies:

"The benefits of privatization result from key differences between how the private and public sectors behave, and the incentives each faces.

For example, the public sector generally uses less capital and is more labour intensive than the private sector. As a result, state-owned enterprises tend to be less productive.

Another essential difference is that governments are preoccupied with fulfilling political goals rather than pursuing economic or business objectives. Instead of allocating capital where it garners the highest economic return, governments typically allocate capital to areas that maximize their chances for re-election.

In addition, government businesses usually operate in a state-provided monopoly shielded from competitive discipline. This means they are not required to constantly update their technologies and production processes and/or offer innovative products and services to their customers. In the private sector, competition forces firms to regularly invest in new capital and meet consumer demand in order to survive and grow profitably.

Finally, government budgets are “soft” since it is impossible for them to go broke. Private sector businesses, however, face “hard” budget constraints. If they incur sustained losses the decline of capital will push them into bankruptcy. The private sector must therefore provide its customers with the quality goods and services they demand, in a timely manner, and at affordable prices. The public sector simply does not face the same pressures."

(See also: Canadian health-care history enough to make you puke ;
see: Healthcare: reform, not rhetoric ;
see: Liberal Healthcare Duplicity, An Ontario Overview 2003-2007 (pg.23) )

Bradley and his McGuinty Ontario Liberals are simply, it appears, treading water until the McCreith - Holmes health care challenge against their government is finally settled.

Until then, their authoritarian Liberal statist monopoly, Ontario's provincial disgrace, will tumble along, with its monopolist head in the sand.

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