Sunday, August 8, 2010

Medicare's head is still in-the-single-payer-status-quo sand

Regarding CMA's recent 2010 report, and Tom Blackwell's Aug.4, 2010 story "Doctors call for pay incentives", the National Post's Aug.5, 2010 editorial was "The CMA doesn't go far enough":

"The Canadian Medical Association’s latest report on the state of health care in Canada makes for sober reading. According to the CMA, our health system fails to deliver on all five founding principles laid out in the 1984 Canada Health Act: universality, accessibility, portability, comprehensiveness and public administration.
   Although notionally universal, the report notes, our health system consistently fails poorer, marginalized populations, which find it more difficult than the better-off to access and navigate an increasingly complex system. Since low-income Canadians generally are more vulnerable to illness, those most in need of care are least likely to get it.
Wait times, the report notes, have been reduced in a few select areas, but delays remain endemic for many treatments and conditions. Five million Canadians lack a family doctor, making access to primary care problematic.
   Many of the benchmarks we use to judge the system date from the establishment of medicare in the 1960s, and the introduction of the Canada Health Act 26 years ago. Much has changed since then. Spending on seniors’ drug coverage and home care has escalated dramatically, yet neither is subject to the Act’s program criteria, and both “are often subject to arbitrary cutbacks.” Similarly, psychiatric hospitals are not covered by the Act. Access to mental-health services remains poor for children and adults alike, despite a growing understanding of the extent to which mental illness afflicts Canadians.
   Too often, the debate over the health system has concentrated on the ability of governments to finance the ever-increasing cost of care. It should be evident by now, to all but the most dogmatic, that the country simply can’t pony up limitless funds for bottomless budgets. Some other approach is needed.
   The CMA has its own list of proposals, which include a re-examination and modernization of the five founding principles of the Health Act, and the creation of a “Charter for Patient-centred Care.”
   A better solution, we think, would be simply to bring Canada in line with virtually every other OECD nation, and create a hybrid system that permits private health-funding options in parallel with a publicly-funded universal health system. As others have noted many times, Canada is the only country in the world, outside of Cuba and North Korea, where garden-variety private health insurance for essential health needs is illegal.
   It is all well and good that the CMA is critiquing the fine points of Canada’s single-payer health model. But until our politicians tear down its Soviet-style proscription of private options, everything else is palliative care."

The above was from Aug.5 2010; but - let's compare and look back to the warning signs about Jeff Turnbull's ascendancy, and the CMA's potential regression back to a medicare-dependency-pushing status-quo, which were noted a year ago, in the National Post's Aug.18, 2009 editorial "Canadian health care is no model":

"The last two presidents of the Canadian Medical Association (CMA) have both been staunch advocates of increased private care. The incoming president, Anne Doig of Saskatoon, who will be installed this week, says our health-care system is "imploding." While not as committed to private options as her predecessors, Dr. Doig acknowledges our current universal public system is "unsustainable." She also argues we should not fear private options, but rather should implement whatever models from around the world -- be they public or private -- that produce the best results for patients. On the other hand, the physician who will replace Dr. Doig next summer, Ottawa's Dr. Jeff Turnbull, promises to be a passionate defender of the government health monopoly during his one-year term.
   Overall, then, three of the four most-recent CMA presidents and presidents-elect have argued to varying degrees that private options for patients are inevitable; just one believes our current government-administered system can be prolonged. Only a dogmatic left-wing outlet such as the Toronto Star editorial page would view this - as it argued in an editorial on Sunday - as proof that a "fresh [pro-medicare] approach may be taking hold" at the CMA, an approach that will "ensure the reactionary American debate over the future of its health care does not poison our own."
   Like most defenders of Canada's health monopoly, the Star misses the point of what is going on Stateside. Contrary to what one might conclude from the clucking and preening exhibited by Canada's friends of medicare, not even those Americans backing guaranteed care for all are holding out our system as their ideal.
   No one in the United States, for example, is calling for a Canada Health Act-like ban on private insurance. Even Barack Obama, while allowing that our system may work for us, was emphatic that the Canadian system "would not work for the United States." No mainstream U. S. politician is calling for the closure of private clinics.
   Indeed, fewer and fewer countries believe, as medicare's defenders do, that it should be illegal for ordinary citizens to use their own after-tax dollars to buy supplemental care. Even major countries with cradle-to-grave social benefits such as France, Germany, the Netherlands, Denmark and Britain, all permit their citizens private options. All allow user fees. Most also permit surgeons to charge thousands of dollars extra for non-emergency, non-life threatening operations, including hip replacements. Even Sweden, long the utopian ideal of the Canadian left, has recently permitted private clinics and hospitals to compete to provide publicly funded procedures. And the Scandinavian sky has not fallen.
   Dr. Doig is neither categorically in favour of private options nor fundamentally opposed. She wants Canadians instead to debate what care they want and how they want it paid for. That strikes us as quite sensible. It is unfortunate her successor is not similarly enlightened."

The above was from 2009: now we see Danielle Martin and Irfan Dhalla predictably cheering the CMA's 2010 report in "CMA's welcome, but belated, change of heart on medicare" (Toronto Star, Aug.6, 2010); and, now we see the predictable anti-patient-choice Aug.7, 2010 obstructionist response to the Post's Aug.5, 2010 editorial from Canadian Nurses Association boss Judith Shamian; obviously the left's sacred, recriminatory head-in-the-single-payer-status-quo-sand ideology (well-described by Keith Martin in "Canada does not have the best health care system in the world" - and he's a Liberal !) is meant to end up in a non-debate (or at best, a hijacked faux-debate - you don't see medicare-monopoly-pushing-doctor-hating-thugs, such as Ontario McGuinty Liberal MPP Jim Bradley, tolerating any "debate"; for Good Ole Jimmy, as with 'man-made-global-warming', the "debate" about monopoly-health-care is "settled"!! There is NO 'debate'.)
Left wing sycophants of Tommy Douglas' failed medicare monopoly socialism are not interested in 'reform', if by "reform" we mean a complete re-think of Tommy-Douglas' failed health care monopolism; and if by "reform" we mean recognizing the need to move towards a hybrid, pro-patient-choice, anti-government-run-monopoly health-care system.
'Reform' to the 'Chaoulli-be-damned' political left (as we've seen in Niagara, as well) does NOT include any notion of more patient choice, but rather, demands MORE OF THE SAME-OLD FAILED GOVERNMENT-RUN, STATIST HEALTH-CARE INTERFERENCE!
It is time for a hybrid health care system; it is time to begin the de-monopolization of Ontario's state-run, Liberal-infected health-care system. Don't allow your local neighbourhood leftists to confuse you with their populist 'universal health-care' rhetoric: single-payer, state-run monopoly health-care is not the same thing as 'universal health-care.'

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