Tuesday, March 1, 2011

De-politicize, De-centralize and De-monopolize Ontario's health-care

Tom Blackwell reported in  "Ottawa must step in to fix health care, doctors say" (National Post, Mar.1, 2011):

  "In a challenge likely to fall flat with the decentralist Harper government, Canada's doctors association urged Ottawa to get off the sidelines and take an active role in fixing Canada's "deeply troubled" health care system.
   Government-run health care is one of the biggest institutions of any kind in North America, noted Dr. Jeff Turnbull, president of the Canadian Medical Association, in a speech Monday to the Empire Club of Canada in Toronto. The system is splintered, however, into 14 divisions -- run by the provinces and territories -- with "14 different IT systems, 14 different purchasing departments, no clear system for sharing best practices and no evaluation of outcomes," he said.
   The federal government's voice has not been heard loudly in recent months as provinces experiment with sometimes controversial changes to the system, including opening the door wider to private medicine. Dr. Turnbull suggested national authorities must play a much bigger part, developing a "health care action plan" that would ensure better use of health workers, apply electronic medical records across the system and launch new measures to make medicare more accountable to the public and patients.
   Just as the Canada Health Act set out the principles of the health-care system a few decades ago, a "bold vision" is needed from federal politicians again to revive the faltering system, he told an Empire Club luncheon.
   "We ask the federal government to demonstrate courage and leadership," Dr. Turnbull said. "We find ourselves at a crossroads and the decisions we take today will be judged by future generations."
   In a question and answer session later, the CMA president admitted the group's call for a federal health-care plan has received a "muted" response from federal politicians of all stripes, which he attributed to a fear of being tripped up by the politically sensitive issue.
   The idea would certainly seem to clash with Prime Minister Stephen Harper's generally decentralist thrust in governing, and the Conservatives' apparent willingness to let provinces shape their own distinct health systems.
   Recent developments involving private clinics in Quebec, B.C. and elsewhere -- some of which opposition politicians have labeled violations of the Canada Health Act -- have generally met with little comment from Leona Aglukkaq, the federal Health Minister.
   Jenny Van Alstyne, a spokeswoman for the minister, refused Monday to directly respond to Dr. Turnbull's proposal, but suggested the government is not keen to tell the provinces what to do.
   "We continue to work with the provinces, territories and health-care professionals to look for ways to improve the health care system," she said in an emailed response to questions Monday.
   Ms. Alstyne said the government is "committed to a universal and public health care system and to the Canada Health Act." She added the Conservatives will not balance the budget by cutting health care, and have increased health transfers to the province by over 30% since coming to power.
   Other recent CMA presidents have spoken out about the need to try different ways of delivering government-funded health care, including giving private operators more opportunities to provide services.
   Dr. Turnbull said he believes discussion of the private-public balance has needlessly polarized the debate, and can be worked out once a plan has been developed to make the system more cost-efficient and effective.
   Meanwhile, the group Canadian Doctors for Medicare released a report Monday that it says shows that it is a myth that rising costs are making the health care system unsustainable.
   In fact, the organization said, public spending on health has remained at a fairly constant level as a portion of the total economy, accounting for 4%-5% of gross domestic product for much of the past 30 years. It has taken up a larger portion of provincial budgets, but that is mainly because of cutbacks in other program areas and tax cuts, the report said.
   On a per capita basis, though, costs have clearly risen sharply, from a provincial average of $1,091 in 1985 to $3,662 in 2010 in current dollars, according to the Canadian Institute for Health Information."
Seems likeTurnbull is advocating nothing but more failing statism. (wasn't Turnbull's conference, BTW, the one which was advertised as "you're health care"??)
Turnbull has mis-diagnosed the political problem facing health-care: that health-care is a single-payer state-controlled monopoly, being manipulated as a social program for political purposes.
Turnbull writes a prescription for more big-government centralist statism and more state socialism, simply ignoring that his consolidationist prescriptions were already tried before - and failed! We are today at a "crossroad" - dealing with the socialist  health-care charade perpetrated by Tommy Douglas' generation!
Turnbull can't bring himself to even use the term 'monopoly' when describing his statist health care ideals and how they relate to the moribund and outdated CHA.
And why is Turnbull not asking Disastrous Dalton's Liberal hacks about what they have done to health-care in Ontario?!
Why isn't Turnbull asking for Liberal McGuinty's... um... "bold vision"?!
Why should 'Ottawa step in'??
Isn't health care a PROVINCIAL responsibility? Do the 14 divisions want 'Ottawa to step in', and take over their constitutional health-care responsibilities? Is this kind of massive monopolist health-care centralization Turnbull's suggested cure?!
No thanks.
See also "Medicare's head is still buried in the single-payer-status-quo sand"

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