Thursday, February 4, 2010

Danny Williams didn't walk the health-care talk

Andre Setton wrote in "Two-tier health care on The Rock?" (National Post, Feb.3, 2010, here)

"Re: N.L. Premier Williams Set To Have Heart Surgery In U.S., Feb. 2. National Post

I think we can all agree that we all wish Premier Danny Williams a complete and speedy recovery.

But his trip to the U.S. for this procedure raises so many questions about our health-care system. Such as:

-Was this procedure not available in Newfoundland or anywhere else in Canada and if so, why not?

-Is this a case of "jumping the queue" because the Premier couldn't wait to have this procedure?

-If the province is paying for the procedure, would any other resident there also be flown to the United States for a similar procedure?

-If Premier Williams (or some private insurance plan) is paying for the procedure, is this not a blatant case of a two-tier system where people who can afford private insurance get options and choices not available to the general public?

And the most important question: The next time any premier defends Canada's single-payer option, will anyone have the courage to ask the him all these questions?"

These are some good questions to ask not only of Williams, but of other big-mouth Canadian single-payer health-care-monopoly-enforcing politicians.

Let's hear Liberal leader Michael Ignatieff pontificate on Williams' running for the American border to obtain cardiac treatment which (we are told, without detail) is supposedly "not an option" in Canada - anywhere. Where's Iggy's smug Liberal outrage?!

A clever Iggy skates around commenting on the issue of Williams' blatant single-payer health-care hypocrisy by saying (here) "the optics are for Mr. Williams to deal with."

What: Ignatieff has NO defense of the single-payer Utopia that his party doggedly bleats on about on any other occasion?! What kind of "optics" does Iggy's own duplicitous non-stand connote?!

Let's hear Iggy pronounce that, unlike Danny Williams, or Belinda Stronach, or Jean Chretien, or Robert Bourassa, he would never travel to the U.S. for health care, no matter what! Then let's hear Iggy accuse others of harbouring secret health care agendas!

Let's for a moment quickly jump back to 2004, and recall Canada's federal-provincial health-care mess under Liberal PM Paul Martin, just after his 'healthcare-billions-"fix" for a generation' fiasco - a year before the Chaoulli decision changed the monopoly-status-quo-landscape (at least in Quebec). Note Williams, in the below story, happily taking Martin's cash; saying that healthcare is not the feds problem: that it's HIS problem, that it's his province's problem.

John Ivison wrote on this theme in "Money will not fix what ails system: Summit was a missed opportunity" (National Post, Sept.17, 2004): [my emphasis in red]

"Paul of Tarsus would have been impressed with the conversion that many of Canada's premiers underwent in the wee hours of yesterday morning. The late unpleasantness was forgotten, even by Danny Williams, the Newfoundland and Labrador Premier, as the first ministers high-fived each other at the conclusion of the 10-year plan to strengthen health care.

Williams, who had previously said that the whole process was a "farce" that could "destroy health care for a generation," was much more emollient after the deal was signed. The vision of dollar signs he saw on the road to the conference centre persuaded him that they had reached an agreement of which everyone could be proud. He did say his province still had serious fiscal problems but told Paul Martin, "It's not your problem ...that's my problem, that's our problem and I don't expect you to fix and heal all those problems." Martin should put such provincial empathy down to sleep deprivation because Williams is unlikely to be as understanding when the premiers crash antlers with the Prime Minister over equalization payments next month.

For his part, Martin's ambition to fix health care for a generation had wilted to merely striking a "deal for a decade." Nonetheless, he proclaimed the agreement as a great day for Canada and one that "adopted the best aspects of the competitive market economy."

As Adam Smith whirled in his grave, it was left for Gary Mar, the stoic Alberta Health Minister, to douse the meeting with cold, hard reality. The deal was, he said, a good start, and one that should improve access to health care across the country. But it was emphatically not a deal for a decade.

"The current iteration of the Canadian health system will not last 10 years. The provinces and the territories will be back," he said.

New technology and skyrocketing drug costs mean that health care inflation runs at a rate of between 6% and 10%, while government revenues increase at around 2% to 4% annually. "Ultimately, even if the federal government's very generous 6% escalator applies to 25% of Canadian health care costs, there are still 75% of Canadian health care costs growing at a much faster rate than 6%."
[my insert: oh, my - didn't Dalton McGuinty know - or remember - that?!]The result, he said, was that Alberta would continue to seek to "innovate" - a euphemism for private delivery - a move that Premier Ralph Klein has already commented could end up breaching the terms of the Canada Health Act.

As the dust settles on the new deal, it would be churlish not to acknowledge that it contains some good things. It is hard to argue with the establishment of comparable indicators, and new benchmarks and targets for wait times.
But the deal essentially provides money to do more of what we are already doing. We may be able to more readily identify problem areas, but there are no provisions for fixing those problems. As jurisdictions around the globe reform their systems to curb runaway costs, Canada has actually buttressed an entrenched status quo.
It's as if no one present at the conference had actually read Senators Michael Kirby and Wilbert Keon's recommendations on achieving efficiencies and productivity gains in health care. The two senators contend that the current fix of throwing more money at the problem "neither works nor is financially sustainable."

Kirby and Keon believe that, while retaining the single public funder principle, an element of competition should be introduced so that hospitals and doctors compete on the basis of price and quality of service. They argue that a monopoly situation exists, which on the labour side means that doctors and nurses wield excessive power and secure pay increases that surpass bargaining in other industries. For example, the Conference Board said median annual earnings for health workers in general rose twice as much in the 1990s as for non-health workers (6.4% versus 3.1%). Health professionals saw wages rise 15.1%. These increases were secured without any consideration for increases in productivity.

The monopoly of hospitals, according to Kirby and Keon, means "they have little incentive to enhance the quality and/or accessibility to their services, to contain or reduce costs or to improve their efficiency or effectiveness." They recommend that procedures such as cataract surgery could be performed much more cheaply in specialized health clinics not constrained by rigid collective agreements because of their lower overheads and more flexible work rules. They believe that the ownership of these clinics is irrelevant, particularly since delivery of health care is almost entirely in private hands anyway (in the form of doctors' private practices and not-for-profit hospitals). The Canada Health Act, they point out, does not restrict private ownership.

The brute reason of many of these arguments seems indubitable, and it is preposterous that they were not even raised at a three-day conference devoted to reforming the health care system for a generation. These are hardly absurd, utopian recommendations. Many of the basic precepts are already being introduced in the United Kingdom, in the face of predictable opposition from public sector unions.

That the real issues at the first ministers conference were buried beneath a welter of self-serving verbiage may have something to do with the fact that a number of provincial governments have made recent moves that actually strengthen the monopoly positions of health care workers and hospitals.

In Ontario, Dalton McGuinty's government purchased three for-profit MRI clinics and required four others to convert to not-for-profit status. In Manitoba, the NDP government purchased a for-profit orthopedic clinic in Winnipeg.
"The purchase of these facilities ... simply means that money will have been taken out of cash-strapped health care budgets and spent in a way that provides no added benefits to patients and does nothing to shorten a single waiting line," wrote Kirby and Keon.

In the final analysis, the health summit was a tragic missed opportunity. Without some discussion of fundamental structural reform, Martin's victory will ultimately prove Pyrrhic. The "transformative change" the Prime Minister envisaged, presumably did not include turning Canada's health system into that of a banana republic rapidly running out of bananas"

Let's hear Banana-republic-leader Dalton McGuinty pledge (ha!) that he too will never go to the States for any kind of health care, no matter what!

"Structural reform"? HAH!! McGuinty, Smitherman, Caplan, Matthews, Bradley and rest of the Grits derided and loathed that concept since their sad election in 2003. For McGuinty's health monopolists, even the sensible, mild Kirby-Keon recommendations were laughed off as ridiculous! (And don't forget how the federal Liberals sanctimoniously crapped all over their own colleague Pierre Pettigrew for his mild suggestions to improve health-care)

Let's hear Liberal MPP Jim Bradley make the promise never to go to those United States, which he hates so much, for health care treatment.

Let's hear from any of these these smug health-monopoly-shoving, Tommy Douglas butt-licking Liberals, Conservatives, and NDPeers that neither they, nor their families, will ever, under any circumstances, go to the U.S. for their health care.

Single-payer-pusher Williams' has run out of bananas, and has made himself a single-payer health-care hypocrite: he had no problem running away from the system which was not good enough for him, yet, at the same time insisting was the ONLY system good enough for the rest of us! Do as I say, not as I do...

As Lorne Gunter wrote in "What's good for Danny Williams..." (National Post, Feb.4, 2010, here)

"...The point I am trying to make here is that only because we have turned health care into a political hot potato are any of us even wondering whether the premier is justified in going to an American clinic.

He is justified in making whatever decision he deems best for his own health, period. Considerations about equity and fairness and the public good have nothing whatever to do with health care and everything to do with politics.

Thankfully, Mr. Williams has enough money that he can fly off to wherever the best care exists. I wouldn't resent him using the money he has earned to buy better care or faster care. I wish him a full and speedy recovery. But why don't the rest of us have the option of escaping socialized medicine, too?

What I resent is the way premiers and prime ministers won't free you or me to buy insurance that would enable us to procure first-class care in times of need. What I resent is the way many limousine liberals lash us to the mast of the good ship Medicare, then run off to the United States when it's their lives or their families' on the line. They are like public school trustees who send their kids to private school.

I don't care whether Mr. Williams gets treatment in St. John's or Cleveland or Timbuktu. But then he and his fellow politicians have to stop caring where I get treatment. They have to stop limiting my health care options just to win political points.

In its 2005 decision in the Chaoulli case, the Supreme court ruled that if Canadian governments could not provide timely heath care they had to permit Canadians to buy insurance for private treatment, whether inside the country or out. It's time governments lived up to that decision - so that perhaps the next time Danny Williams needs his heart fixed, he doesn't have go to the United States. "   

The NDP and Liberals don't even believe in the Chaoulli ruling, and both accuse the Conservatives of harbouring a scary "secret agenda" (you've heard it; you've heard your paranoid friends repeat it -  to "create" a two tier system: a system which was informally created by none other than Chretien and Martin!! But why quibble with Canada's history of Liberal healthcare duplicity?

Here's Lorrie Goldstein's comment in "Have a heart, Danny, please speak up" (St.Catharines Standard, Feb.4, 2010, here):

"If Newfoundland and Labrador Premier Danny Williams urgently needed heart surgery that could not be performed in Canada, all he has to do is say so and the controversy over his decision to seek medical care in the U.S. will end.

Even if Williams, a millionaire who donates his salary as premier to charity, paid for it himself, it's hard to criticize anyone for using their own resources to seek the best medical care available.

This as opposed to having the operation done in Canada, and possibly having to wait in line, simply to make a political statement in support of medicare. (Newfoundland's medical wait times are among the longest in Canada.)

Deputy Premier Kathy Dunderdale said Williams' surgery wasn't available in Newfoundland, but not whether it could have been performed in Canada.

Vickie Kaminksi, head of Newfoundand's largest health authority, said Williams - who hasn't publicly commented - acted on the recommendations of local doctors, who referred him out-of-province.

But Canadian experts like pioneering heart surgeon Dr. Wilbert Keon-a Conservative senator -told theGlobe and Mailthere's "no question" Williams could have chosen treatment in Canada. Alberta cardiac surgeon Dr. Arvind Koshal said Williams was setting a bad example, adding: "The optics are very poor, especially for people who are proponents of the Canadian health-care system."

Opponents of President Barack Obama's medicare initiative in the U.S. are chortling Williams is just the latest Canadian politician to opt for U.S. health care.

More significantly, our Supreme Court in 2005 - citing wealthy individuals who could bypass wait times under medicare by heading south - ruled Quebec's law banning private medical insurance, and by implication similar laws across Canada, were unconstitutional because they denied patients the ability to seek timely care when medicare can't provide it.

Our politicians claim they've addressed that issue by shortening wait times, although many patients disagree.

If it turns out Williams headed to the U.S. for faster care, it raises the issue of why our governments continue to prevent us from buying private medical insurance so more of us can avoid medicare's line-ups, as the wealthy do by travelling south."

Well, let's ask Liberals Dalton McGuinty, Deb Matthews, Jim Bradley, and Kim Craitor that same question which Goldstein asks: Why do Ontario's Liberals ignore the precedent of Chaoulli and continue to prevent Ontarians from buying private health insurance, so that more of us can avoid Ontario's McGuinty-made medicare line-ups?

Let's ask the McGuinty gang the same question Gunter asks: Why don't Ontarians have the option of escaping socialized medicine too - in our own province, not in another country?

Look forward to your answers, Dalton, Deb, Jim, and Kim. Oh, and seeing as Michael Ignatieff is an Ontario MP, we look forward to his answer as well. (note: these Liberal dirtbags never did bother to respond...)

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