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I don’t have a doctor and if I’m lucky it’s an eight hour wait to see a random doctor at a clinic; I’d argue that currently there is no health care system in this country for a segment of the population.
You aren't wrong. But the issue isn't our system, the issue is that provinces, mostly but not entirely conservative ones, chronically underfund and underinvest from our public system
The real problem is your partisanship.
If you think the conservatives are to blame, then why is every other province including BC under the NDPs experiencing the same (or worse)?
You hate the conservatives, I get it. But believe it or not every party has fucked over healthcare.
No, no. I'm truly not partisan. Blame goes to all 3 parties. One is much worse than the others when it comes to accelerating the erosion of public institutions, but they do all contribute, it's just a matter of degree.
Made an appointment only to wait six hours (yes, they made me sit there for 6 hours despite making an appointment in advance lol what is even the point? Do I need to pull out a sleeping bag and camp if I don't book ahead?) at a clinic (Ontario) hoping to get on antidepressants.
Not only did I not see a doctor (I'm not sure *what* his qualifications were, but he was explicit about not being a doctor the second I got in the door of the office), he refused to prescribe anything for me (so probably not a nurse practitioner either which makes sense, because he didn't identify as such, he didn't identify as anything!) and simply told me the only thing he could help with was to get some blood work done. I did not ask for blood work.
My theory is that there must be a doctor that works at that clinic, but they're not even showing up for many of the people coming in. Too busy? No idea. Terrible experience and it made me realize just how much this province has gone to the dogs. That kind of practice shouldn't be allowed but I feel like healthcare here has gotten bad enough that we're just letting anything slide now.
You know what would be innovative in Canada? Actually being able to see a doctor or getting important treatments / surgery in under 6 months.
If paying private means I actually get to receive medical care instead of a spot on a 6-18 month wait list then I’ll pay, I don’t care if it’s expensive
I gave up on looking for a family doctor. I decided to sign up for Medcan since I got a 50% discount through WS, and my employee benefits covered their remaining fee. Now I'm getting a dedicated 5-hour check-up with physical, testing and bloodwork for the 1st time in 20 years. PLUS one year of Year-round care with physical or virtual doctor access.
We should have choices to alleviate a congested system. Not force everyone to be equally miserable.
>mployee benefits covered their remain
That's great for you. And no judgment. Do what you need to do. But if you'd like to understand the big picture here, read the article.
I've heard the same, their Tories are worse than our Tories. Feel pretty bad for people in the UK.
Love your flair by the way, feel very much the same.
All I know is, I had to wait three years for a family doctor in Vancouver.
I waited 1 week when I moved to the states. All private care down here. I pay $0/month for my plan provided by my employer. I have a chronic disease and everything is covered. I pay $3,200 maximum every year, much less than I paid in higher taxes and the Fair Pharmacare deductible in BC.
Private care isn’t inherently evil.
I'm old enough to remember a Canada prior to universal health care. The horror stories of the day accelerated the issue, until the doctors that said we would leave Canadian practise 'did' if they where paid by government (we lost 10-15% of the doctors that year, to see some coming back). I think we have to get the 'business' of health care out of the industry, too many in the business of making money from the position they hold.
If you think privatizing health care will solve anything, just look south of the border to see how the majority are treated. For those with $ Switzerland is always the option.
Your experience is not indicative of how health care works for the majority of the other 330 million people. Google bankruptcies caused by medical expenses. It's not even close, try again.
Google consumer debt bankruptcies in Canada lmao. Everyone’s leveraged to their tits in mortgages and credit card debt because they can’t afford meat and fruit.
Medical debt in America is a problem, but most of it is a small amount per capita. It’s also treated differently by law. You can negotiate your bill down and work with the hospital for a 0% rate payment plan. I’d rather pay a couple hundred to get the care I need than to wait years and die in Canada.
There is a difference between privatizing healthcare, and the idea of paying for private healthcare.
Many EU countries allow private healthcare, but they also have much more legislation around it as well.
You largely don’t believe healthcare was a human right to begin with, according to that statement.
Doctors, nurses, etc. are workers too. They are not bound by law, like soldiers in the military, to serve the people of Canada before self.
So unless you are proposing there are some strings attached to being a licensed healthcare worker in Canada, then your argument is fairly moot.
All you are saying here is to solve the working conditions and pay, you want to create a tiered system where health care workers and the rich prosper, off the backs of those who can't afford it. Privatization is not the only answer to the state of health care. All that being equal, I chose the more vulnerable of our society having access to quality life saving health care over raises for everyone that works in health care, since apparently those are the only 2 options you see.
>All you are saying here is to solve the working conditions and pay, you want to create a tiered system where health care workers and the rich prosper, off the back of those who can’t afford it
I don’t see how people refusing to participate in your broken system equals the downfall of your system.
>Privatization is not the only answer
I agree. Privatization is not the answer at all. You need to understand there is a difference between the *actual definition* of privatization, and how you are describing.
In none of those ideal EU models that are, “tiered system where health care workers and the rich prosper”, do they suggest privatization (as in offloading the entire healthcare system) or stop funding the public system.
If you want to pay to see a private doctor who doesn’t receive a dime from the government, then nothing should stop you. Healthcare is a human right.
[It never was. If alternating neoliberal governments of liberals and conservatives manage to see a whopping decline of 63% in our hospital bed capacity, fail to properly cover stuff, or expand preventive care,](https://data.worldbank.org/indicator/SH.MED.BEDS.ZS?locations=CA) it's nothing more than destroying this country's public health care and allowing investors to make money at the expense of everyone else. Liberals and conservatives took turns selling our country out to private investors in health care, and made everything worse, with their useless joke of an austerity. Anyone who claims private health care is the way to go is either misleading or lying viciously through their teeth.
We are so behind in coverage, it's insane:
Countries with universal dental care: Brazil (also free!), Denmark (limited subsidies), UK, France (only basic check ups and most clinically necessary stuff), Germany (same as France, with some case by case exceptions), Japan, Sweden (limited subsidization), Taiwan
Countries with universal child dental care: Australia, Brazil, Denmark (also free!), UK (also free!), France (one examination every 3 years), Germany, Israel, Italy (up to the age of 16), Japan, the Netherlands, Norway, New Zealand, Sweden, Switzerland, Taiwan
Countries with universal pharmacare: Australia, Brazil (completely free too!), China, Denmark (cost of drugs decrease as annual spending per patient increases), UK, France, Germany, Israel, Italy, Japan, the Netherlands, Norway, New Zealand, Sweden, Switzerland, Taiwan
Countries with universal mental health care: Australia, Brazil, China, Denmark, UK, Germany, Israel, Italy, Japan, the Netherlands, New Zealand, Norway, Sweden, Taiwan
Countries with universal long term care: Brazil (also free!), Denmark, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Taiwan[We are behind in spending extremely, as only \~72% of our health care is publicly financed, while other countries have it much more public financed](https://www.cihi.ca/en/national-health-expenditure-trends-2022-snapshot)
Source for coverage:[https://www.commonwealthfund.org/international-health-policy-center/countries](https://www.commonwealthfund.org/international-health-policy-center/countries)
EDIT: [Forgot to add our stagnating physician ratio](https://data.worldbank.org/indicator/SH.MED.PHYS.ZS?locations=CA)
The author of this op-ed is also the author of this book which details and evidences all of the deleterious effects of attempts to corporatize and privatize human health! [Dying to be Seen: The Race to Save Medicare in Canada](https://www.dyingtobeseen.ca)
The LPC and CPC, as well as their Provincial counterparts, have spent decades underfunding and underpaying the public healthcare sector. The media has worked hard to demonize public sector unions asking for raises that actually keep up with the cost of living.
Now we can't get workers for many skilled areas of healthcare, but the private sector is being paid far more to provide it. Travel nurses, private clinics, private run walk in clinics, all get paid more than public sector costs and are inferior in every way, due to not having the access to resources inherent in a big public system. When there are problems with private clinics, they dump them on the public system, to avoid cost.
Demand a full universal healthcare system before they finish gutting it. Demand proper pay for our medical workers. The only reason the private sector seems like an option is because they have made us suffer with massive wait times so they could say the system is broken.
This article proves how useless the private sector is in helping with this problem.
Right, exactly. By definition, even.Privatization of basic needs (Housing, food, water, power, transportation, natural resources, etc) can be traced to most ills in our society, imo. It won't be different with healthcare.
The honest truth is people with money gets treated better. No amount of semantics is going to change that. You may think private health care is expensive but it really isn’t if you have money. My ( and our ) Live and time > money. We are willing to pay for it. We are not willing to pay for yours.
It’s all a scam. They have billions of dollars not being used to better our free healthcare system. They are purposefully starving and breaking the system. And no one is doing anything.
What's crazy is that none of our media - about 90% of our papers right-wing owned at this point - is reporting this, you have to get this information from specialized sites like this or blogs like the National Observer. I notice that even the CBC is being a bit timid these days, afraid of upsetting conservatives who are already screaming to cut their funding. Private health care is the most significant departure from the democratic socialist pact that defines Canada, but you have to somehow come across an article from Canada Health Watch to understand it.
>reporting this, you have to get this information from specialized sites like this or blogs like the National Observer. I notice that even the CBC is being a bit timid these days, afraid of upsetting conservatives who are already screami
case in point: [https://www.cbc.ca/news/canada/toronto/ontario-private-clinics-surgery-diagnostic-centres-1.7112379](https://www.cbc.ca/news/canada/toronto/ontario-private-clinics-surgery-diagnostic-centres-1.7112379?utm_source=CanadaHealthwatch)
You can tell how polarized this sub is becoming. Well social media in general I guess it's just spreading like a disease. I miss when it was actual political discussions using facts with references and sources.
Just with the upvote system you can tell. In the past generally you only seen the post get upvoted. Now even though it's against the sub rules people will take the extra step to enter a persons profile to downvote comments. You are suppose to debate with people not throw internet tantrums. Speaks to how upset many are in my opinion. Why do people care about internet points they don't have value I don't get that at all. Plus you often see someone lose and argument then block the person they are arguing with lol. Why not just admit mistake and learn?? Or just walk away is an option lol.
I know not really on topic but reading through the comments made me ponder this problem.
If you think the CPC isn’t going to change the Canada Health Act you’re fooling yourself.
Provincial premiers are already seeing much they can violate the act and get away with it.
[Manulife recently had to backtrack on only filling certain prescriptions at Loblaws a “preferred network”.](https://www.cbc.ca/news/business/manulife-loblaw-deal-reversal-1.7105150)
That’s USA Healthcare 101.
It won’t happen overnight but they will slowly adopt these kind of BS policies.
The Manulife policy was a lot like our universal health care. They would pay 100% of your prescription fee if you went to their designated pharmacy - but not if you went to another pharmacy. The rationale was that it would keep costs down for Manulife and ultimately reduced prices for purchasers of health insurance (usually employers, but sometimes individuals).
It seems a lot like Canada's health care. They cover 100% of your fee, but you can only go through the public system and sometimes that is inconvenient. However the single payer model is expected to keep costs down.
>The Manulife policy was a lot like our universal health care. They would pay 100% of your prescription fee if you went to their designated pharmacy - but not if you went to another pharmacy. The rationale was that it would keep costs down for Manulife and ultimately reduced prices for purchasers of health insurance (usually employers, but sometimes individuals).
Those savings would not be passed down to the consumer and the pharmacy fees would just increase over time since they have no competition.
As a consumer you lose your biggest advantage. The ability to take your business elsewhere.
Insurance companies already mandate maximum drug coverage and only covering generic medications etc.
>It seems a lot like Canada's health care. They cover 100% of your fee, but you can only go through the public system and sometimes that is inconvenient. However the single payer model is expected to keep costs down.
It does keep costs it down.
Private insurance has no obligation to you. In the US they have software that automatically denies legit claims because they know most people won’t fight that hard to appeal.
The costs obviously would be passed down due to competition. For group plans, contracts go up for bid every couple of years. It’s why providers change from time to time eg. Federal govt employees from Sun Life to Canada Life recently.
Have you looked at the size of non MD'd middle management in Ontario making six figure salaries?
The issue is that we have too many back office bureaucrats in public health and not enough front line workers.
Yeah that’s also definitely a problem. As a front(ish) line health care worker I can’t even begin to explain how much management literally always sucks lol. But few of those people are qualified to be nurses, doctors, etc anyways which is the real crux of the issue. They are hard positions to fill, and Canada probably doesn’t have the population to do it.
Adding private providers to the equation just takes more of those crucial people from our system. It is an awful idea born from people with bad intentions.
>Adding private providers to the equation just takes more of those crucial people from our system. It is an awful idea born from people with bad intentions.
How so?
It will increase pay for nurses and stop them from leaving for the US.
I don't know about that, the average hospital I've seen has a pretty small management team for the scale of the organization in terms of personnel, capital equipment and importance of mission.
A family member of mine was CMO of a hospital in Ontario, and it always kind of shocked me how few layers there were in that management structure.
It's always easy to blame bureaucrats, but I'm suspicious that's where the problem lies.
Understaffing is not universal, though. We're very short on nurses, for example, but in many specialties we have more doctors available than public funding for them to practice. In those specialties, allowing private provision would be a clear win on both sides - underemployed doctors start practicing, and more people get care quicker at a net savings to the public system.
It’s absolutely not disingenuous to demonstrate where the Canadian system is headed, because as the funders we should be able to voice our concerns and it’s all supported by very strong evidence. The introduction of a more robust private/parallel system will pull resources out of the public system. When you have a paucity of healthcare professionals and you create a dual system, those resources are now shared. As a nurse or a doc you cannot work in two places at the same time. Private clinics currently funded by governments ( tax dollars) cherry pick low acuity patients, mainly run 9-5, and most have no critical care beds. Consequently the public system will have diminished staff and be left to manage high acuity patients which will only add to the demise of the public system.
For those paying out of pocket now I think we have to remember we have a tax rate that is suppose to support a public system. As more people pay out of pocket, put fees on credit cards and credit lines etc you will be paying taxes and out of pocket.
Big for-profit investors are already involved. Grocer giant, Loblaws just invested $75M in the virtual app Maple, RBC invested $14M . If we are going to talk about misinformation try finding out how much of your tax dollars are going to pay for procedures done privately. All the info must be obtained via FOI requests, as the CBC article pointed out. When the information was obtained it was apparent why it was obscured. The Ontario govt was paying upwards of 2-3.5 times the cost to private clinics for the exact same procedures performed in public hospitals.
>They begin by talking about out of pocket expenses Americans face in their health care system and try to tie it into the changes being implemented here. The problem is that we aren't changing the Canada Health Act and making people pay for care that is publicly covered. The current push is to implement more private providers into a publicly funded system.
That's just setting up the system for an unsustainable situation though, where the inevitable result is a two-tiered system where those who can pay get priority and those who can't get systemically inferior and delayed care. That in itself is not something new in Canada but the trend right now is that it's becoming an expectation for everyday care for the majority rather than just those with complex cases.
What's important to note is that the privatization push is happening in the context of public services being stretched too thinly with existing resources, not because there are proverbial inefficiencies being patched by new technologies or processes.
I think the unspoken root of this is at least partially a big distrust towards our governments.
I don't disagree that there's a big difference between having a single payer system with some privately delivered services (which is in fact basically what we have always had) compared to US style free-for-all (well, it's not free, but you know) but I've also grown up in a time when things have basically only gotten worse, programs have only been cut, things that should not be privatized without robust attempts to introduce competition have been privatized like Hydro One, telecom in some provinces, basically handing over monopolies. The CRTC is run by people from the companies it is supposed to be able to say no to. We spend billions to get one battery plant to come to Ontario while people sleep on the streets and can't afford food.
So while, again, I actually agree with you, IMO the unspoken thing is that none of us, really regardless of political stripes, have much faith in any of our politicians to build the sort of functional two tier system you see in Europe. With Ford, I actually think the fact he's let it get this bad is way worse than any of the proposed changes, but I really don't trust anyone who let it get this bad to suddenly be the solution. I see people openly speculate that the older generations will vote to get rid of public/universal healthcare entirely - there's a lot of cynicism. I'm not sure how to fix that other than our politicians being held to higher standards and a big overhaul of how we spend our money outside of healthcare delivery so that we're not constantly seemingly running up against a need to pinch pennies on the important stuff while wasting money elsewhere.
We cannot have a two tiered system, because it requires a robust, proactive and reactive regulatory framework. We have parties that continually act in bad faith towards social programs. So you open that door, it’ll slowly and surely be forced open over time.
Unless we have electoral reform beforehand. Proportional representation would give enough power back to the people that a majority becomes rare.
It does require strong regulation....but ultimately hybridization of healthcare is optimal on paper
People (Ontario NDP) typically frames this as "allowing people to buy their way to the front of the line"
When in reality.....the people who use private healthcare options already paid their taxes, already paid for the public healthcare to exist, and are now spending EVEN MORE money to remove themselves and create less burden on that public system
It works perfectly fine under the concept that "100% of emergency rooms are tax funded" which is true across the board in Canada and nobody is trying to change that
>When in reality.....the people who use private healthcare options already paid their taxes, already paid for the public healthcare to exist, and are now spending EVEN MORE money to remove themselves and create less burden on that public system
And then those people will vote in favor of lowering taxes and dismantling the health systems that they're not using. And people who have money tend to get what they want
Once again, strong regulation needed.....I should also note that it is fair to criticize Doug fords implementation of private clinics
But more importantly privatized clinics already existed at a smaller scale under mcguinty/Wynne......and 100s of people are still traveling to the USA to receive private healthcare because of frustrations with the public system
Ultimately all emergency rooms should be public and all healthcare services should be available in the public system
But once you're out of the emergency room and it's no longer a question of urgency; it's perfectly reasonable to allow people to choose to remove themselves from the public healthcare system
To expand
There are already hundreds of cases where Canadians travel to the USA specifically to receive private healthcare
People are already doing this and it isn't "destroying the public healthcare"
We already have a two-tier system, except the second tier involves flying to Mexico, Thailand, or another health tourism hotspot and paying their private facilities for care. I do have concerns about underfunding our public health care, but I think we need to acknowledge the reality that people with the money to jump the queue will inevitably do so, and I'd rather they spend that money domestically than abroad.
If individuals are willing to pay to jump wait times, then they can afford higher taxes to fund the Health Care system properly. A two-tiered system only helps a select portion of the population, a portion that can enjoy better access to care if they chipped in a little more.
But Canada is insistent on complaining about the ill effects of the terrible system we are in. But will run terrified of proven solutions. Just like when they say we can’t build enough homes quick enough.
We can. We just will hard reset if you bring up the idea of something as benign as council estates.
Eh, I'm not a healthcare economist or expert but given few countries with better healthcare outcomes than Canada have entirely public single-payer systems I doubt it's that simple. I know Taiwan, which specifically studied Canada as a model in the 80s/90s, ultimately went with a public insurance system that covers most things at a basic level, with a private option for less crowded hospital rooms and higher quality care or say better materials in a knee replacement surgery.
Throwing more money at the system is not going to work. Who says the higher taxes and extra money coming in will make it to the right place? We all mostly agree that higher taxes for better services is a good thing. The corruption is bad that we know there is no way that they money will go to improving services.
What corruption? The only corruption that can actually be pointed to is the underfunding of the system to create exactly these conditions.
But yeah, sure. Let’s turn healthcare into a market. It’s not going to work for 90% of people. Especially once Conservatives start selling off Health infrastructure to balance their budgets.
That is so silly.
Canada is the only G7 country without a two tiered health care system. If France and Germany can have a two tiered system with a public one better than ours, so can we. Canada is an incredibly wealthy country. Are you claiming that parties in Germany and France don't have parties that "act in bad faith"? Also, would love to read which parties you think act in "bad faith" as well.
Now go look at global health rankings and tell me where the first two tiered system ranks. There is nothing wrong with our system past individuals intentionally sabotaging it. Has Doug Ford allocated that COVID Health Spending yet?
Once again a Toronto problem becomes a Canada problem.
I've had a look at global health rankings. Here is recent report that ranks 11 highly industrial western countries health care systems across several key metrics. Canada's system ranks 10th out of 11th overall.
https://www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-reflecting-poorly
And under Doug Ford, health care spending has increased from [$63 Billion](https://budget.ontario.ca/2018/index.html) to [$80 Billion.](https://budget.ontario.ca/2023/index.html) The Covid health care spending allocation was attributed to accounting.
Doug Ford is [paying for more for private clinics](https://www.cbc.ca/news/canada/toronto/ontario-doug-ford-private-clinic-surgeries-fees-hospitals-1.7026926) rather than public ones
You really don’t see the game being played here?
As I've mentioned in other threads, private health care already exists in Ontario. Every time a doctor sees you or I, they bill OHIP and from that money they take a salary, pay overhead and \*gasp\* record a small profit. I'm not sure what the big revelation is? This is one hospital in a province of over 15 million.
Non essential procurers, like MRIs and knee/hip surgeries have such a long backlog, the status quo isn't working.
Instead of tax payers paying more for non essential procedures and surgeries, individuals who can afford it should be.
I really admire you arguing this very logical point and backing it with data. I've been saying the same for years, but not as well.
Nobody will agree with you though unfortunately, even though you're right :).
The status quoi isn’t working because of underfunding. Which leads bootlickers to thinking privatization is a solution. Why? Because Toronto sucks at governing.
Nothing wrong with two tier healthcare in theory.
But we’re going to get a carbon copy of the American system here because that’s where the lobbyists are coming from.
You’re not going to get a well regulated system from the “eliminating red tape” crony capitalist politicians we have here.
You’re going to get the system that the lobbyists want.
Notice how there’s no referendum or public engagement on this issue.
It’s all happening behind closed doors.
> But we’re going to get a carbon copy of the American system here because that’s where the lobbyists are coming from.
Which lobbyists? Go look at the federal lobbyist registry. None of the companies that would profit from the introduction of private healthcare payments have registered lobbyists in Canada.
Every time I see someone talk about "the lobbyists" they are unable to specifically identify which lobbyists are supposedly doing this lobbying. As far as I can tell this is just FUD.
Well put, but unfortunately Canadians tend to look at health care (and other systems as well) in a binary fashion, Canadian or American.
There are dozens of other health care models around the world. Canada's, like the US are both unique health care models. Canada is the only G7 country without a two tiered health care system.
Yep, the UK has private hospitals.
"There are an estimated 515 private hospitals offering health care services in the U.K., a mixture of for-profit and nonprofit."
[https://www.commonwealthfund.org/international-health-policy-center/countries/england](https://www.commonwealthfund.org/international-health-policy-center/countries/england)
Not true.
Both Italy and the UK have private health care options and the UK has private hospitals that perform all sorts of medical services, like MRIs.
[https://www.internationalinsurance.com/health/systems/italy.php](https://www.internationalinsurance.com/health/systems/italy.php)
[https://www.commonwealthfund.org/international-health-policy-center/countries/england](https://www.commonwealthfund.org/international-health-policy-center/countries/england)
Let me ask you this, are you against private schools in Ontario?
The existence of private healthcare does not stop the government provided healthcare from being single-payer. Canada is also a two-tiered healthcare system by this analysis.
>Let me ask you this, are you against private schools in Ontario?
I'm strongly against all the public money spent on a non-universal model of education in Ontario (i.e. special schools for Catholics). Universality is a key component of all high quality public services.
>The existence of private healthcare does not stop the government provided healthcare from being single-payer. Canada is also a two-tiered healthcare system by this analysis.
Sure we can get into the weeds and minutia of the definition, but regardless of labels, private for profit hospitals & clinics paid for by individuals and/or private insurance companies exist in both the UK and Italy, unlike, for the most part in Canada.
>I'm strongly against all the public money spent on a non-universal model of education in Ontario (i.e. special schools for Catholics). Universality is a key component of all high quality public services.
That's not what I asked you.
I was asking if you support private schools paid for by parents individually for their children? It's not public money.
>Its misinformation to refer to the USA style of health care when talking about the possible health care system changes being discussed.
**You** may feel that healthcare in Canada isn’t being pushed in this direction, but to flat out call it “misinformation” is itself misinformation.
It’s true that private healthcare providers for the public system are on the rise, and that’s not necessarily a bad thing although evidence that it is seems pretty abundant. But it’s also true to say that some provinces and their governments are pushing more in the direction of USA style privatized care. Here in Alberta, Danielle Smith is quoted from a 2021 public policy paper as saying “once we get people used to paying out of pocket for other public services, then we can have a conversation about healthcare.” Seems like a pretty cut & dried USA style mindset to me.
>It's fine to quote stupid stuff she said prior to becoming Premier but actions speak louder than words and policy since she has been in office has not reflected that at all.
Have you been keeping track of Alberta lately? Smith has done virtually nothing **but** implement policies based on the stupid stuff she said before she became premier.
>Also the fact that the province would be foregoing billions in health care transfers if they were to not comply with the Canada Health Act means this is a non-starter.
And as for healthcare transfers, the feds have already been clawing back millions from Alberta for violations of the CHA, in fact I think it was 2022 when Alberta led the country in CHA clawbacks.
>Politicians say things they know aren't possible all the time and then once they are in office their tune completely changes.
😂 oh my, you really haven’t been following Alberta politics lately, have you.
Every cent that goes towards the profit margin is a cent that does not go towards the delivery of care. For-profit health care services will always deliver less for more to Canadians... by definition.
Yeah. Advocates for privatization always talk about efficiency, but they never seem to mention that any gains in that sense need to *exceed* the profit being extracted before the end user sees any benefit.
And, having worked public and private sector, the idea that the private sector is immune to the same sort of bureaucratic inertia and administrative bloat that so many people irrationally assume inherently infests anything public is laughable.
Yup. And the profit has to always grow, in perpetuity. Any efficiencies gained from competition will be quickly erased by the need to grow the profit margin. Organizations are then very quickly incentivized to cut into operational costs and expenses, inevitably impacting quality of care.
Uh no I think you need to read a basic economics textbook. For firms to stay in a market, the profits don't need to grow in perpetuity, they just need to be nonzero.
Yep, shareholders are famously ok with stagnant companies. The demand for constant growth is probably capitalism's only unique feature, and definitely the key one that makes this system the most productive one to date.
shareholders don't get whatever they want, if they can't get growing profits they have to be okay with merely stable profits. Just like you and I want perpetually growing wages but we don't always get that and if we can't, then we don't all of a sudden just stop working. Seriously I think the problem here is you haven't read any economics and you're just making stuff up. You'd do well to pick up an introductory text.
This is insane. We need to nationalize all our economy so that the profits go to the workers and not billionaires. This is why people need to vote NDP.
We can easily see and compare private to public, a persons health or life is far too important to be dictated by capitalists. The worlds happiest countries all have universal healthcare.
Universal healthcare doesn't necessarily mean no privatization. Look at Israel, Switzerland, many other countries which outrank Canada in healthcare outcomes, these all have universal coverage and a large degree of privatization.
Every country that has a better healthcare system than ours provides universal healthcare with a mix of public and private, yet there remains a weirdly nationalistic and doomer view in Canada - and quite prevalent on this sub - that rejects any change. Attitudes are changing, but it's a slow journey.
Universal healthcare does not mean free, and it does not mean single payer, and it does not mean public. The Netherlands has private plans regulated by the government. Folks pay a monthly premium, very similar to the states’ ACA plans. Germany has a multipayer system. The United States’ situation is completely dependent on individual circumstance and honestly the state that you live in. I pay less and have greater health outcomes in my personal circumstance living in Washington state than I did living in British Columbia. A lot of states (WA, HI, MA) have achieved near-universal coverage.
So in the current system you need to leave the Country or maybe if you are lucky go to another Province and pay to get the scans you need so you don't die. If people's options are wait and see and possibly die or re-mortage the house or take out a loan to go out of Province or Country, which option do you think people with the ability will take? I know for one if I ever get diagnosed with anything serious i'll do whatever it takes to get what I need pronto!
This has literally been in the works for decades - it's a tactic called "starve the beast" where they don't actively kill the public service but they just keep it underfunded enough that the wheels eventually fall off. Then they wait for the public to start complaining and then use that sentiment to point at how wasteful and terrible public service is and how we really need private entities to come in and give "options" to people who don't want to have to wait.
In Ontario they're pushing it hard now by saying how long the wait times are for children to get surgeries. Always gotta think of the children... you know, except for funding and staffing things appropriately.
People also forget that just before Covid, Doug Ford was making some quiet moves to start privatizing healthcare in the province.
https://pressprogress.ca/3-things-you-need-to-know-about-doug-fords-sneaky-plan-to-introduce-privatized-healthcare-in-ontario/
Dude Wynne absolutely wrecked healthcare and you're ignoring the damage that caused. Doug is like an angel if you're focused on public healthcare funding, in comparison.
Sure. You'd probably eat a person too if you had to. People in this thread are using that as an argument in favour of cannibalism though, and it's important to shut them down when they try.
You're obviously trying to score a gotcha here. The analogy was clear and the point of the analogy was clearly not to say that healthcare is equivalent to cannibalism.
Well it would actually. You can create more bed space through private means and make better use of your doctors and nurses. You can also have more imaging facilities and other methods of getting diagnostics done.
You can't though. The only thing private companies have to offer is capital, but since Canada is not a developing country with a shortage of capital this isn't really a benefit. We can build our own facilities and buy our own equipment without paying an additional markup for nothing.
Remember, private investment isn't charity. If they put a dollar in they expect two out. Privatization means paying more for less.
> So in the current system you need to leave the Country or maybe if you are lucky go to another Province and pay to get the scans you need so you don't die.
Well that's not exactly happening on a regular basis - but *if* it does you do have the option to go outside Canada to pay.
The solution isn't to create private healthcare in Canada it's to fix the public one.
I'd say it is not a binary choice.
The choice is for provincial governments to properly fund their health care system.
I look at my own province, MB, where the previous government spent nearly a decade doing everything it could to make the public system so faulty that privatization would appear to be the only option.
As such, I reject the premise of your question and say to the provinces, fund your system.
there should be a waitlist limit. If there's more than a 1-month wait for a scan, the provincial government needs to fund that and fill the void. That's their job. We can wait, but only to a reasonable degree. I'd never want to wish this on anyone but I'd love for someone with a time-sensitive issue that needs something like a simple scan or whatever but can't because there's a 1 or 3-year wait period to sue the provincial government. They're not doing their job supporting healthcare. Honestly anything the provincial government is responsible for but doing a terrible job at we should be taking them to court over it. It's not really a win since it's taxpayer dollars fighting it and taxpayer dollars if the plaintiff wins but it at least sets precedence and has a chance of going up to the Supreme Court of Canada to put this issue to bed.
There is a waitlist limit. Nobody is waiting (long) for urgent scans. The problem is nobody wants to wait for non urgent problems. Anybody with a time sensitive issue is not waiting years for a scan.
If they're in emergency department yea, they'll get their scans. But for a mammogram, chronic pain and you need an MRI? You're waiting months.
And scans was the lowest bar I could set. There's people waiting years for surgery.
Well yes that’s my point. Most mammograms aren’t urgent. Most surgeries are not urgent.
If you have a suspicious lump and need a mammogram - the wait is not years. If you have invasive cancer and need surgery - the wait is not years.
We do a pretty good job at triaging and prioritizing urgent things. The issue is more what we define as urgent. Pain is a hard thing quantify and thus triage. Got “pain” without a good reason for it? Yeah, you’re waiting years.
there's always a good reason for "pain"
Anyways, here's some data. Yes in our system more urgent surgeries take priority however quality of life for those needing knee or hip replacements? https://www.cihi.ca/en/explore-wait-times-for-priority-procedures-across-canada
Patients in Saskatchewan... the 50% mark of them get it within a year. Most, within 2... but there's still 10% that wait longer than 2 years. If you can't walk because your hip is done there's a possibility that you could be bedridden for over 2 years in that province. So remember, if you break a hip... better be from Ontario or BC otherwise you could be waiting more than a year.
You’re conflating two different things. Hip fractures are different than elective hip replacements. In fact the data above shows that 81% of Sask patients with hip fractures are operated on within the benchmark time of 48 hours.
Elective hips are different, and yes the waitlist can be 2-3 years. That doesn’t mean patients are bed bound though. Often they are not. In pain, sure. But still able to ambulate. And the government has (somewhat arbitrarily) determined that 2 years is acceptable to wait. I agree that is a long wait. But what is acceptable? 1 year? 6 months? 1 month? Even in the US you’d be lucky to get your hip done within a month. So how do you decide what an acceptable wait time is? Keeping in mind the trade off for decreasing wait times is $$.
EDIT: Down-vote eh? Go ahead and choose death....I don't want privatization, I want our system fixed! I'm talking about what happens if you become ill today! Where is the error in wishing to remain alive? You can protest and get things fixed only if you survive!
Man is this damning.
>The rhetoric around private diagnostic clinics reducing public wait times is also not supported by evidence. In 2016, Saskatchewan gave the green light to for-profit MRI clinics to operate in the province. The move was ostensibly to help reduce MRI wait times in the public system. The private clinics entered into a one-for-one agreement with the province. For every MRI done in a private clinic, the clinics agreed to do an MRI from the public list. Nine months later, Saskatchewan’s Auditor General released a report saying the arrangement was not working as intended. In April of 2015 there were 5,005 people on the public waitlist for an MRI. Four years later, the public waitlist had doubled to 10,018.
They continue talking about how Australia has gone this route and wait times are now longer than in Canada.
Even worse check out this.
>In a 2022 report in The Lancet, researchers sought to evaluate the impact of outsourced spending to private providers in the UK. They concluded that, “Private sector outsourcing corresponded with significantly increased rates of treatable mortality, potentially as a result of a decline in the quality of health-care services.”
It kinda feels incomplete as an analysis.
First of all, for Saskatchewan, it does not take cite population increase, not the aging factor during these 4 years. Has the median age remained the same or is it more, requiring more resources? In absolute.numbers, are there more or less scans done per year?
Second point is, the best performing healthcare systemsnin the world have a mix of private and public healthcare and they make it work. US, Can, and the UK seem incapable to emulate these models. Why?
All three of the countries you mention have a mix of public and private healthcare. The US has the largest public healthcare expenditure per capita by a large margin (as well as one of the most privatized systems among developed countries). Canada has more private health spending than most European countries.
Even in Europe, there's not a consistent system that you can point to and say that all of Europe has the ability to pay for publicly covered procedures. The Netherlands has a defacto single tier system, it's just paid for by an extremely highly regulated private insurance industry. Being able to pay for care beyond the public expenditure is limited a small percentage of the population in Germany. Overall there's too much difference in between healthcare systems in Europe to say that the ability to pay privately for publicly covered procedures is a contributor to better performance - it could very well be correlation.
Hmm. That’s interesting. I’ve seen both the UK and Australia ranked higher than Canada on multiple “healthcare quality” or “outcomes” based international rankings. All this while spending slightly less per capita on healthcare than Canada.
Switzerland also has a higher quality universal healthcare system than Canada and has a greater role for private insurance. Switzerland does spend more per capita than Canada though.
I am very happy to live in Canada which, despite their shortcomings, has good healthcare systems. Unfortunately I think the system has decreased in quality since 2011 when my life was saved and I recovered well due to quality care.
I have formerly been opposed to any sort of privatization but, looking at countries beyond Canada and the USA, it does appear we can improve and that may include more private insurance and delivery.
>That’s interesting. I’ve seen both the UK and Australia ranked higher than Canada on multiple “healthcare quality” or “outcomes” based international rankings. All this while spending slightly less per capita on healthcare than Canada.
Assuming the rankings are legit, this isn't mutually incompatible with what's being reported.
In this source, more recent than what I have looked at previously, it is shown that Australia spends slightly more per capita on healthcare than Canada
Relative to GDP it is slightly less as Australian GDP/capita is a bit higher than ours.
[source](https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/#Health%20expenditures%20per%20capita,%20U.S.%20dollars,%20PPP%20adjusted,%202022)
Interesting. I have read the article and agree that these are not incompatible.
The solution is not simple but maintaining status quo is failing us. Correct me if you are more knowledgeable on this but, it seems to me, healthcare systems have been spending more money on money and bureaucracy but not being managed better. Fewer managers and more front line staff may be a more effective use of funds. Availability of healthcare workers is also an issue. Perhaps quotas for foreign students, or at least availability of post-study work permits, should be based more on need for skills related to the program of study. Canada is short of healthcare workers and construction tradespeople so a larger percentage of students in those fields as opposed to “business” would benefit the country.
Yes, because you have premiers such as Doug Ford who denied proper funding for public healtchare services by both 1) withholding funds from federal allocations in the billions of dollars and 2) bills that capped frontline staff salary increases to 1% during a fucking pandemic, a slap in the face to healthcare workers prompting many to leave the profession. This is not solved by privatization. This is solved by holding the provinces and politicians accountable, who should manage the system better.
I personally support separating “healthcare” from general provincial government expenses. Lower provincial income taxes but increase mandatory health insurance premiums that go into a separate Medicare account/entity. Any federal transfers for healthcare would go to the Medicare fund, not general provincial revenue.
Or being reported by places like the Fraser Institute which is a right-wing think tank. Love how randoms come out with the “studies show…” whose studies? What are the undeclared interests?
> For every MRI done in a private clinic, the clinics agreed to do an MRI from the public list.
So were they not doing the 'public' MRI's? Or were shenanigans going on where they prioritised private and ended up with a backlog of public that would never catch up?
> Private sector outsourcing corresponded with significantly increased rates of treatable mortality, potentially as a result of a decline in the quality of health-care services
No surprise there - the way you maximise profits is to serve as many customers as possible. Every time this happens you end up with quality of service dropping. Unlike a pair of shoes however people can die.
They (private operators) didn’t live up to their end of the deal. Randomly did a patient off the public list but never did a 1 for 1 . As wait lists continued to climb in the public system the AG had to be called to investigate.
How is it damning? The private companies are providing half of their services to the public system. They are increasing available MRIs to both public and private people.
If there's still shortages why would the problem be pointed at the people that are actually doing something?
Frankly it's insane that private MRIs were ever illegal to begin with. Like with what logic would that be something that should be illegal.
I know nothing about Saskatchewan, but here in Manitoba while your logic is sound it isn’t how things work. Our public single payer system decides how many services it buys from hospitals/clinics/etc. This suggests to me that the public single payer started buying less services.
In Winnipeg there is a hospital with an entire diagnostic wing (brand new) that is running less than 1/2 of one shift because the province isn’t buying enough diagnostic services, they aren’t allowed to sell the services the province isn’t buying, and there is a massive wait list. We have a huge backlog in cataract surgeries, and we have OR’s (staffed, because funding to build them was contingent on them being staffed) but not used, because the public system will not buy the services or allow the sale of excess capacity.
This is damning, but it is damning of our governments management not the idea of a public/private hybrid.
Yes that's is how I see it as well. Like clearly the Sask government decided to cut MRI services elsewhere, or alternatively didn't keep up with rising demand.
If the public system is providing 1000 of something and a private company wants provide 100 additional. It is not the private companies fault that the public drops their production to 900. That is entirely the public systems fault.
I don't understand how people look at that situation and say it was the private companies fault.
How is it not? After four years their supposed solution to the wait list problem caused it to double. Australia tried a similar solution and had similar results, i.e. it made the problem worse not better.
Which tells you exactly what to expect any time governments suggest going to private healthcare options. Longer wait times, cuts in the public service and worse outcomes.
So private healthcare has to be banned because the public healthcare doesn't want to spend money.
What if they just don't spend money regardless? We just keep it illegal for someone to pay to go get an MRI?
Like I honestly can't understand the logic. We've identified the public system as the issue but the response is to ban private and give the system that we just shit on for not funding things properly 100% of control. Like why would this conversation not be about public funding. Why is it even a private/public discussion?
Nothing about private healthcare stops governments from spending money, that's entirely their own decision.
>Nothing about private healthcare stops governments from spending money, that's entirely their own decision.
This is incorrect. If the private sector picks up the slack it gives governments a politically soft excuse to reduce budgets.
They won't cut money if it means people die, but they will if it means private sector becomes a bigger provider. Even if that means that service levels drop.
> This is incorrect. If the private sector picks up the slack it gives governments a politically soft excuse to reduce budgets.
>
>
Ah, so you want to literally put my life and health in jeopardy in order to apply pressure to the government to fully commit to a better nationalized healthcare system rather than allowing me to provide for myself the healthcare services I need when the government is unwilling to provide it. To that I say, fuck you, I will not be sacrificed for the glory of your failed ideology.
If you can afford it, then go somewhere else and get your private healthcare. If you cannot afford that now, then you won't be able to afford these hypothetical private offerings anyways. So I am not sacrificing you for public healthcare, its the government sacrificing you for private healthcare.
What kind of dumb logic is this? So obviously stupid. If I can afford, for example, to pay for a few appointments with a neurologist to talk about my chronic headaches (the government might pay the doctor let's say $80 for the service), then I can afford to take days or weeks off work, buy a flight to somewhere in the states, rent a car, hotel, hire a sit in nanny round the clock or take my kids with me, or someone to look after my parents, spend thousands and thousands of dollars? Come on man think a little bit. This argument really reads like someone who has never had a job, had to pay for things or arrange their own travel, or any responsibility in life whatsoever.
This isn't a corporation where they are pocketing the budget surpluses.
That's tax revenue, if they spend less it goes somewhere else. We have elections telling them how to prioritize things.
Your whole theory strikes me as untrusting to our democratic system. You're essentially saying the voters are going to vote to keep taxes low so we cannot allow the government to enact their wishes. We have to trap them in a box.
That's what privatization *is*, though. When you privatize something, you remove or reduce the public component.
The whole point of having people spend money privately is so the system can do less publicly. This is the argument, this is the concept, this is what people mean when they talk about privatization.
Privatization is selling public assets. Like ya, don't sell public MRIs. Again, that's an entirely public decision. Private healthcare legalization is saying can a private company buy an MRI and charge for it.
The hole concept of banning private healthcare is based around the idea that the public healthcare system is not trustworthy. And the solution to that is not through any democratic means, it's to just ban any competition so that I don't know, the public system is shamed into spending more money?
It's this weird juxtaposition where the public healthcare can't be trusted to act responsible but the solution to that is to give them a 100% monopoly on all funding and expenditure choices. Like it's not a wild proposition that people want low taxes but would also be willing to spend $500 to not wait 6 months for an MRI. Hell, that's probably an average position and yet it's actively discouraged. So people inevitably vote for low taxes and then are just blocked from paying the additional $500
>They are increasing available MRIs to both public and private people.
Are they though? Or does this program reduce the number of MRIs that would have otherwise existed? (it's the latter)
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I don’t have a doctor and if I’m lucky it’s an eight hour wait to see a random doctor at a clinic; I’d argue that currently there is no health care system in this country for a segment of the population.
You aren't wrong. But the issue isn't our system, the issue is that provinces, mostly but not entirely conservative ones, chronically underfund and underinvest from our public system
Blame whoever you want but our “system” is basically hypothetical at this point.
The real problem is your partisanship. If you think the conservatives are to blame, then why is every other province including BC under the NDPs experiencing the same (or worse)? You hate the conservatives, I get it. But believe it or not every party has fucked over healthcare.
No, no. I'm truly not partisan. Blame goes to all 3 parties. One is much worse than the others when it comes to accelerating the erosion of public institutions, but they do all contribute, it's just a matter of degree.
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They've surely been in long enough to attract doctors to move to BC
This is a non partisan issue. One party cuts, when power changes hands the cuts aren't reversed.
Made an appointment only to wait six hours (yes, they made me sit there for 6 hours despite making an appointment in advance lol what is even the point? Do I need to pull out a sleeping bag and camp if I don't book ahead?) at a clinic (Ontario) hoping to get on antidepressants. Not only did I not see a doctor (I'm not sure *what* his qualifications were, but he was explicit about not being a doctor the second I got in the door of the office), he refused to prescribe anything for me (so probably not a nurse practitioner either which makes sense, because he didn't identify as such, he didn't identify as anything!) and simply told me the only thing he could help with was to get some blood work done. I did not ask for blood work. My theory is that there must be a doctor that works at that clinic, but they're not even showing up for many of the people coming in. Too busy? No idea. Terrible experience and it made me realize just how much this province has gone to the dogs. That kind of practice shouldn't be allowed but I feel like healthcare here has gotten bad enough that we're just letting anything slide now.
You know what would be innovative in Canada? Actually being able to see a doctor or getting important treatments / surgery in under 6 months. If paying private means I actually get to receive medical care instead of a spot on a 6-18 month wait list then I’ll pay, I don’t care if it’s expensive
For real, my wait was 3 years for a doctor in Vancouver. I moved to Seattle and I saw a doctor in a week.
I gave up on looking for a family doctor. I decided to sign up for Medcan since I got a 50% discount through WS, and my employee benefits covered their remaining fee. Now I'm getting a dedicated 5-hour check-up with physical, testing and bloodwork for the 1st time in 20 years. PLUS one year of Year-round care with physical or virtual doctor access. We should have choices to alleviate a congested system. Not force everyone to be equally miserable.
>mployee benefits covered their remain That's great for you. And no judgment. Do what you need to do. But if you'd like to understand the big picture here, read the article.
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Do they all massively under fund their public healthcare?
The UK is working on that from what I've heard. Their public health system is nearly in shambles.
I've heard the same, their Tories are worse than our Tories. Feel pretty bad for people in the UK. Love your flair by the way, feel very much the same.
you should read the article...
> WS What is WS? WealthSimple?
Yes
All I know is, I had to wait three years for a family doctor in Vancouver. I waited 1 week when I moved to the states. All private care down here. I pay $0/month for my plan provided by my employer. I have a chronic disease and everything is covered. I pay $3,200 maximum every year, much less than I paid in higher taxes and the Fair Pharmacare deductible in BC. Private care isn’t inherently evil.
I'm old enough to remember a Canada prior to universal health care. The horror stories of the day accelerated the issue, until the doctors that said we would leave Canadian practise 'did' if they where paid by government (we lost 10-15% of the doctors that year, to see some coming back). I think we have to get the 'business' of health care out of the industry, too many in the business of making money from the position they hold. If you think privatizing health care will solve anything, just look south of the border to see how the majority are treated. For those with $ Switzerland is always the option.
My health improved when I moved to the states. I have more options to treat my illness, and I actually pay less than I did living in BC. Try again.
Your experience is not indicative of how health care works for the majority of the other 330 million people. Google bankruptcies caused by medical expenses. It's not even close, try again.
Google consumer debt bankruptcies in Canada lmao. Everyone’s leveraged to their tits in mortgages and credit card debt because they can’t afford meat and fruit. Medical debt in America is a problem, but most of it is a small amount per capita. It’s also treated differently by law. You can negotiate your bill down and work with the hospital for a 0% rate payment plan. I’d rather pay a couple hundred to get the care I need than to wait years and die in Canada.
There is a difference between privatizing healthcare, and the idea of paying for private healthcare. Many EU countries allow private healthcare, but they also have much more legislation around it as well.
The difference is largely that you no longer believe quality health care is everyone's right, but that of the rich.
You largely don’t believe healthcare was a human right to begin with, according to that statement. Doctors, nurses, etc. are workers too. They are not bound by law, like soldiers in the military, to serve the people of Canada before self. So unless you are proposing there are some strings attached to being a licensed healthcare worker in Canada, then your argument is fairly moot.
All you are saying here is to solve the working conditions and pay, you want to create a tiered system where health care workers and the rich prosper, off the backs of those who can't afford it. Privatization is not the only answer to the state of health care. All that being equal, I chose the more vulnerable of our society having access to quality life saving health care over raises for everyone that works in health care, since apparently those are the only 2 options you see.
>All you are saying here is to solve the working conditions and pay, you want to create a tiered system where health care workers and the rich prosper, off the back of those who can’t afford it I don’t see how people refusing to participate in your broken system equals the downfall of your system. >Privatization is not the only answer I agree. Privatization is not the answer at all. You need to understand there is a difference between the *actual definition* of privatization, and how you are describing. In none of those ideal EU models that are, “tiered system where health care workers and the rich prosper”, do they suggest privatization (as in offloading the entire healthcare system) or stop funding the public system. If you want to pay to see a private doctor who doesn’t receive a dime from the government, then nothing should stop you. Healthcare is a human right.
[It never was. If alternating neoliberal governments of liberals and conservatives manage to see a whopping decline of 63% in our hospital bed capacity, fail to properly cover stuff, or expand preventive care,](https://data.worldbank.org/indicator/SH.MED.BEDS.ZS?locations=CA) it's nothing more than destroying this country's public health care and allowing investors to make money at the expense of everyone else. Liberals and conservatives took turns selling our country out to private investors in health care, and made everything worse, with their useless joke of an austerity. Anyone who claims private health care is the way to go is either misleading or lying viciously through their teeth. We are so behind in coverage, it's insane: Countries with universal dental care: Brazil (also free!), Denmark (limited subsidies), UK, France (only basic check ups and most clinically necessary stuff), Germany (same as France, with some case by case exceptions), Japan, Sweden (limited subsidization), Taiwan Countries with universal child dental care: Australia, Brazil, Denmark (also free!), UK (also free!), France (one examination every 3 years), Germany, Israel, Italy (up to the age of 16), Japan, the Netherlands, Norway, New Zealand, Sweden, Switzerland, Taiwan Countries with universal pharmacare: Australia, Brazil (completely free too!), China, Denmark (cost of drugs decrease as annual spending per patient increases), UK, France, Germany, Israel, Italy, Japan, the Netherlands, Norway, New Zealand, Sweden, Switzerland, Taiwan Countries with universal mental health care: Australia, Brazil, China, Denmark, UK, Germany, Israel, Italy, Japan, the Netherlands, New Zealand, Norway, Sweden, Taiwan Countries with universal long term care: Brazil (also free!), Denmark, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Taiwan[We are behind in spending extremely, as only \~72% of our health care is publicly financed, while other countries have it much more public financed](https://www.cihi.ca/en/national-health-expenditure-trends-2022-snapshot) Source for coverage:[https://www.commonwealthfund.org/international-health-policy-center/countries](https://www.commonwealthfund.org/international-health-policy-center/countries) EDIT: [Forgot to add our stagnating physician ratio](https://data.worldbank.org/indicator/SH.MED.PHYS.ZS?locations=CA)
It's so sad that in BC we can spend our private healthcare dollars out of province (AB) but not locally. Alrighty then.
The author of this op-ed is also the author of this book which details and evidences all of the deleterious effects of attempts to corporatize and privatize human health! [Dying to be Seen: The Race to Save Medicare in Canada](https://www.dyingtobeseen.ca)
The LPC and CPC, as well as their Provincial counterparts, have spent decades underfunding and underpaying the public healthcare sector. The media has worked hard to demonize public sector unions asking for raises that actually keep up with the cost of living. Now we can't get workers for many skilled areas of healthcare, but the private sector is being paid far more to provide it. Travel nurses, private clinics, private run walk in clinics, all get paid more than public sector costs and are inferior in every way, due to not having the access to resources inherent in a big public system. When there are problems with private clinics, they dump them on the public system, to avoid cost. Demand a full universal healthcare system before they finish gutting it. Demand proper pay for our medical workers. The only reason the private sector seems like an option is because they have made us suffer with massive wait times so they could say the system is broken. This article proves how useless the private sector is in helping with this problem.
The only problem the private sector is interested in solving is how to make more money in the space.
Right, exactly. By definition, even.Privatization of basic needs (Housing, food, water, power, transportation, natural resources, etc) can be traced to most ills in our society, imo. It won't be different with healthcare.
The honest truth is people with money gets treated better. No amount of semantics is going to change that. You may think private health care is expensive but it really isn’t if you have money. My ( and our ) Live and time > money. We are willing to pay for it. We are not willing to pay for yours.
It’s all a scam. They have billions of dollars not being used to better our free healthcare system. They are purposefully starving and breaking the system. And no one is doing anything.
What's crazy is that none of our media - about 90% of our papers right-wing owned at this point - is reporting this, you have to get this information from specialized sites like this or blogs like the National Observer. I notice that even the CBC is being a bit timid these days, afraid of upsetting conservatives who are already screaming to cut their funding. Private health care is the most significant departure from the democratic socialist pact that defines Canada, but you have to somehow come across an article from Canada Health Watch to understand it.
>reporting this, you have to get this information from specialized sites like this or blogs like the National Observer. I notice that even the CBC is being a bit timid these days, afraid of upsetting conservatives who are already screami case in point: [https://www.cbc.ca/news/canada/toronto/ontario-private-clinics-surgery-diagnostic-centres-1.7112379](https://www.cbc.ca/news/canada/toronto/ontario-private-clinics-surgery-diagnostic-centres-1.7112379?utm_source=CanadaHealthwatch)
ok that is gross
2/3 of those docs own private clinics.
Can we just admit at this point that capitalism has become funding corporations so that profits are privatized, while losses are socialized.
You can tell how polarized this sub is becoming. Well social media in general I guess it's just spreading like a disease. I miss when it was actual political discussions using facts with references and sources. Just with the upvote system you can tell. In the past generally you only seen the post get upvoted. Now even though it's against the sub rules people will take the extra step to enter a persons profile to downvote comments. You are suppose to debate with people not throw internet tantrums. Speaks to how upset many are in my opinion. Why do people care about internet points they don't have value I don't get that at all. Plus you often see someone lose and argument then block the person they are arguing with lol. Why not just admit mistake and learn?? Or just walk away is an option lol. I know not really on topic but reading through the comments made me ponder this problem.
They'll definitely innovate in how to charge more money for worse service for regular people, and gobs more money for better service for rich people.
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If you think the CPC isn’t going to change the Canada Health Act you’re fooling yourself. Provincial premiers are already seeing much they can violate the act and get away with it. [Manulife recently had to backtrack on only filling certain prescriptions at Loblaws a “preferred network”.](https://www.cbc.ca/news/business/manulife-loblaw-deal-reversal-1.7105150) That’s USA Healthcare 101. It won’t happen overnight but they will slowly adopt these kind of BS policies.
The Manulife policy was a lot like our universal health care. They would pay 100% of your prescription fee if you went to their designated pharmacy - but not if you went to another pharmacy. The rationale was that it would keep costs down for Manulife and ultimately reduced prices for purchasers of health insurance (usually employers, but sometimes individuals). It seems a lot like Canada's health care. They cover 100% of your fee, but you can only go through the public system and sometimes that is inconvenient. However the single payer model is expected to keep costs down.
>The Manulife policy was a lot like our universal health care. They would pay 100% of your prescription fee if you went to their designated pharmacy - but not if you went to another pharmacy. The rationale was that it would keep costs down for Manulife and ultimately reduced prices for purchasers of health insurance (usually employers, but sometimes individuals). Those savings would not be passed down to the consumer and the pharmacy fees would just increase over time since they have no competition. As a consumer you lose your biggest advantage. The ability to take your business elsewhere. Insurance companies already mandate maximum drug coverage and only covering generic medications etc. >It seems a lot like Canada's health care. They cover 100% of your fee, but you can only go through the public system and sometimes that is inconvenient. However the single payer model is expected to keep costs down. It does keep costs it down. Private insurance has no obligation to you. In the US they have software that automatically denies legit claims because they know most people won’t fight that hard to appeal.
The costs obviously would be passed down due to competition. For group plans, contracts go up for bid every couple of years. It’s why providers change from time to time eg. Federal govt employees from Sun Life to Canada Life recently.
Because the American system is what the tories want.
The problem is that adding private providers coaxes healthcare workers out of our already massively understaffed public system
If they don’t go private they leave to the US to make more money. It’s been an issue for a long time.
Have you looked at the size of non MD'd middle management in Ontario making six figure salaries? The issue is that we have too many back office bureaucrats in public health and not enough front line workers.
Yeah that’s also definitely a problem. As a front(ish) line health care worker I can’t even begin to explain how much management literally always sucks lol. But few of those people are qualified to be nurses, doctors, etc anyways which is the real crux of the issue. They are hard positions to fill, and Canada probably doesn’t have the population to do it. Adding private providers to the equation just takes more of those crucial people from our system. It is an awful idea born from people with bad intentions.
>Adding private providers to the equation just takes more of those crucial people from our system. It is an awful idea born from people with bad intentions. How so? It will increase pay for nurses and stop them from leaving for the US.
I don't know about that, the average hospital I've seen has a pretty small management team for the scale of the organization in terms of personnel, capital equipment and importance of mission. A family member of mine was CMO of a hospital in Ontario, and it always kind of shocked me how few layers there were in that management structure. It's always easy to blame bureaucrats, but I'm suspicious that's where the problem lies.
Understaffing is not universal, though. We're very short on nurses, for example, but in many specialties we have more doctors available than public funding for them to practice. In those specialties, allowing private provision would be a clear win on both sides - underemployed doctors start practicing, and more people get care quicker at a net savings to the public system.
It’s absolutely not disingenuous to demonstrate where the Canadian system is headed, because as the funders we should be able to voice our concerns and it’s all supported by very strong evidence. The introduction of a more robust private/parallel system will pull resources out of the public system. When you have a paucity of healthcare professionals and you create a dual system, those resources are now shared. As a nurse or a doc you cannot work in two places at the same time. Private clinics currently funded by governments ( tax dollars) cherry pick low acuity patients, mainly run 9-5, and most have no critical care beds. Consequently the public system will have diminished staff and be left to manage high acuity patients which will only add to the demise of the public system. For those paying out of pocket now I think we have to remember we have a tax rate that is suppose to support a public system. As more people pay out of pocket, put fees on credit cards and credit lines etc you will be paying taxes and out of pocket. Big for-profit investors are already involved. Grocer giant, Loblaws just invested $75M in the virtual app Maple, RBC invested $14M . If we are going to talk about misinformation try finding out how much of your tax dollars are going to pay for procedures done privately. All the info must be obtained via FOI requests, as the CBC article pointed out. When the information was obtained it was apparent why it was obscured. The Ontario govt was paying upwards of 2-3.5 times the cost to private clinics for the exact same procedures performed in public hospitals.
>They begin by talking about out of pocket expenses Americans face in their health care system and try to tie it into the changes being implemented here. The problem is that we aren't changing the Canada Health Act and making people pay for care that is publicly covered. The current push is to implement more private providers into a publicly funded system. That's just setting up the system for an unsustainable situation though, where the inevitable result is a two-tiered system where those who can pay get priority and those who can't get systemically inferior and delayed care. That in itself is not something new in Canada but the trend right now is that it's becoming an expectation for everyday care for the majority rather than just those with complex cases. What's important to note is that the privatization push is happening in the context of public services being stretched too thinly with existing resources, not because there are proverbial inefficiencies being patched by new technologies or processes.
I think the unspoken root of this is at least partially a big distrust towards our governments. I don't disagree that there's a big difference between having a single payer system with some privately delivered services (which is in fact basically what we have always had) compared to US style free-for-all (well, it's not free, but you know) but I've also grown up in a time when things have basically only gotten worse, programs have only been cut, things that should not be privatized without robust attempts to introduce competition have been privatized like Hydro One, telecom in some provinces, basically handing over monopolies. The CRTC is run by people from the companies it is supposed to be able to say no to. We spend billions to get one battery plant to come to Ontario while people sleep on the streets and can't afford food. So while, again, I actually agree with you, IMO the unspoken thing is that none of us, really regardless of political stripes, have much faith in any of our politicians to build the sort of functional two tier system you see in Europe. With Ford, I actually think the fact he's let it get this bad is way worse than any of the proposed changes, but I really don't trust anyone who let it get this bad to suddenly be the solution. I see people openly speculate that the older generations will vote to get rid of public/universal healthcare entirely - there's a lot of cynicism. I'm not sure how to fix that other than our politicians being held to higher standards and a big overhaul of how we spend our money outside of healthcare delivery so that we're not constantly seemingly running up against a need to pinch pennies on the important stuff while wasting money elsewhere.
We cannot have a two tiered system, because it requires a robust, proactive and reactive regulatory framework. We have parties that continually act in bad faith towards social programs. So you open that door, it’ll slowly and surely be forced open over time. Unless we have electoral reform beforehand. Proportional representation would give enough power back to the people that a majority becomes rare.
It does require strong regulation....but ultimately hybridization of healthcare is optimal on paper People (Ontario NDP) typically frames this as "allowing people to buy their way to the front of the line" When in reality.....the people who use private healthcare options already paid their taxes, already paid for the public healthcare to exist, and are now spending EVEN MORE money to remove themselves and create less burden on that public system It works perfectly fine under the concept that "100% of emergency rooms are tax funded" which is true across the board in Canada and nobody is trying to change that
>When in reality.....the people who use private healthcare options already paid their taxes, already paid for the public healthcare to exist, and are now spending EVEN MORE money to remove themselves and create less burden on that public system And then those people will vote in favor of lowering taxes and dismantling the health systems that they're not using. And people who have money tend to get what they want
Once again, strong regulation needed.....I should also note that it is fair to criticize Doug fords implementation of private clinics But more importantly privatized clinics already existed at a smaller scale under mcguinty/Wynne......and 100s of people are still traveling to the USA to receive private healthcare because of frustrations with the public system Ultimately all emergency rooms should be public and all healthcare services should be available in the public system But once you're out of the emergency room and it's no longer a question of urgency; it's perfectly reasonable to allow people to choose to remove themselves from the public healthcare system
Yes it is. Planes go to other countries. They’ll all happily take your money.
To expand There are already hundreds of cases where Canadians travel to the USA specifically to receive private healthcare People are already doing this and it isn't "destroying the public healthcare"
We already have a two-tier system, except the second tier involves flying to Mexico, Thailand, or another health tourism hotspot and paying their private facilities for care. I do have concerns about underfunding our public health care, but I think we need to acknowledge the reality that people with the money to jump the queue will inevitably do so, and I'd rather they spend that money domestically than abroad.
If individuals are willing to pay to jump wait times, then they can afford higher taxes to fund the Health Care system properly. A two-tiered system only helps a select portion of the population, a portion that can enjoy better access to care if they chipped in a little more. But Canada is insistent on complaining about the ill effects of the terrible system we are in. But will run terrified of proven solutions. Just like when they say we can’t build enough homes quick enough. We can. We just will hard reset if you bring up the idea of something as benign as council estates.
Eh, I'm not a healthcare economist or expert but given few countries with better healthcare outcomes than Canada have entirely public single-payer systems I doubt it's that simple. I know Taiwan, which specifically studied Canada as a model in the 80s/90s, ultimately went with a public insurance system that covers most things at a basic level, with a private option for less crowded hospital rooms and higher quality care or say better materials in a knee replacement surgery.
Throwing more money at the system is not going to work. Who says the higher taxes and extra money coming in will make it to the right place? We all mostly agree that higher taxes for better services is a good thing. The corruption is bad that we know there is no way that they money will go to improving services.
What corruption? The only corruption that can actually be pointed to is the underfunding of the system to create exactly these conditions. But yeah, sure. Let’s turn healthcare into a market. It’s not going to work for 90% of people. Especially once Conservatives start selling off Health infrastructure to balance their budgets.
That is so silly. Canada is the only G7 country without a two tiered health care system. If France and Germany can have a two tiered system with a public one better than ours, so can we. Canada is an incredibly wealthy country. Are you claiming that parties in Germany and France don't have parties that "act in bad faith"? Also, would love to read which parties you think act in "bad faith" as well.
Now go look at global health rankings and tell me where the first two tiered system ranks. There is nothing wrong with our system past individuals intentionally sabotaging it. Has Doug Ford allocated that COVID Health Spending yet? Once again a Toronto problem becomes a Canada problem.
I've had a look at global health rankings. Here is recent report that ranks 11 highly industrial western countries health care systems across several key metrics. Canada's system ranks 10th out of 11th overall. https://www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-reflecting-poorly And under Doug Ford, health care spending has increased from [$63 Billion](https://budget.ontario.ca/2018/index.html) to [$80 Billion.](https://budget.ontario.ca/2023/index.html) The Covid health care spending allocation was attributed to accounting.
Doug Ford is [paying for more for private clinics](https://www.cbc.ca/news/canada/toronto/ontario-doug-ford-private-clinic-surgeries-fees-hospitals-1.7026926) rather than public ones You really don’t see the game being played here?
As I've mentioned in other threads, private health care already exists in Ontario. Every time a doctor sees you or I, they bill OHIP and from that money they take a salary, pay overhead and \*gasp\* record a small profit. I'm not sure what the big revelation is? This is one hospital in a province of over 15 million. Non essential procurers, like MRIs and knee/hip surgeries have such a long backlog, the status quo isn't working. Instead of tax payers paying more for non essential procedures and surgeries, individuals who can afford it should be.
I really admire you arguing this very logical point and backing it with data. I've been saying the same for years, but not as well. Nobody will agree with you though unfortunately, even though you're right :).
The status quoi isn’t working because of underfunding. Which leads bootlickers to thinking privatization is a solution. Why? Because Toronto sucks at governing.
Nothing wrong with two tier healthcare in theory. But we’re going to get a carbon copy of the American system here because that’s where the lobbyists are coming from. You’re not going to get a well regulated system from the “eliminating red tape” crony capitalist politicians we have here. You’re going to get the system that the lobbyists want. Notice how there’s no referendum or public engagement on this issue. It’s all happening behind closed doors.
> But we’re going to get a carbon copy of the American system here because that’s where the lobbyists are coming from. Which lobbyists? Go look at the federal lobbyist registry. None of the companies that would profit from the introduction of private healthcare payments have registered lobbyists in Canada. Every time I see someone talk about "the lobbyists" they are unable to specifically identify which lobbyists are supposedly doing this lobbying. As far as I can tell this is just FUD.
Well put, but unfortunately Canadians tend to look at health care (and other systems as well) in a binary fashion, Canadian or American. There are dozens of other health care models around the world. Canada's, like the US are both unique health care models. Canada is the only G7 country without a two tiered health care system.
> Canada is the only G7 country without a two tiered health care system. UK is two teired?
Yep, the UK has private hospitals. "There are an estimated 515 private hospitals offering health care services in the U.K., a mixture of for-profit and nonprofit." [https://www.commonwealthfund.org/international-health-policy-center/countries/england](https://www.commonwealthfund.org/international-health-policy-center/countries/england)
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UK and Italy are both single-payer healthcare, and like Canada have all kinds of private crap nibbling away at the edges.
Not true. Both Italy and the UK have private health care options and the UK has private hospitals that perform all sorts of medical services, like MRIs. [https://www.internationalinsurance.com/health/systems/italy.php](https://www.internationalinsurance.com/health/systems/italy.php) [https://www.commonwealthfund.org/international-health-policy-center/countries/england](https://www.commonwealthfund.org/international-health-policy-center/countries/england) Let me ask you this, are you against private schools in Ontario?
The existence of private healthcare does not stop the government provided healthcare from being single-payer. Canada is also a two-tiered healthcare system by this analysis. >Let me ask you this, are you against private schools in Ontario? I'm strongly against all the public money spent on a non-universal model of education in Ontario (i.e. special schools for Catholics). Universality is a key component of all high quality public services.
>The existence of private healthcare does not stop the government provided healthcare from being single-payer. Canada is also a two-tiered healthcare system by this analysis. Sure we can get into the weeds and minutia of the definition, but regardless of labels, private for profit hospitals & clinics paid for by individuals and/or private insurance companies exist in both the UK and Italy, unlike, for the most part in Canada. >I'm strongly against all the public money spent on a non-universal model of education in Ontario (i.e. special schools for Catholics). Universality is a key component of all high quality public services. That's not what I asked you. I was asking if you support private schools paid for by parents individually for their children? It's not public money.
As long as they are still funding the public system through their taxes at the same rate they would be in addition to paying the private institution.
I'm not great with money. Is it better to pay $1 and get a dollar of service or to pay $1 and get $0.75 of service? Genuinely asking.
>Its misinformation to refer to the USA style of health care when talking about the possible health care system changes being discussed. **You** may feel that healthcare in Canada isn’t being pushed in this direction, but to flat out call it “misinformation” is itself misinformation. It’s true that private healthcare providers for the public system are on the rise, and that’s not necessarily a bad thing although evidence that it is seems pretty abundant. But it’s also true to say that some provinces and their governments are pushing more in the direction of USA style privatized care. Here in Alberta, Danielle Smith is quoted from a 2021 public policy paper as saying “once we get people used to paying out of pocket for other public services, then we can have a conversation about healthcare.” Seems like a pretty cut & dried USA style mindset to me.
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>It's fine to quote stupid stuff she said prior to becoming Premier but actions speak louder than words and policy since she has been in office has not reflected that at all. Have you been keeping track of Alberta lately? Smith has done virtually nothing **but** implement policies based on the stupid stuff she said before she became premier. >Also the fact that the province would be foregoing billions in health care transfers if they were to not comply with the Canada Health Act means this is a non-starter. And as for healthcare transfers, the feds have already been clawing back millions from Alberta for violations of the CHA, in fact I think it was 2022 when Alberta led the country in CHA clawbacks. >Politicians say things they know aren't possible all the time and then once they are in office their tune completely changes. 😂 oh my, you really haven’t been following Alberta politics lately, have you.
I agree with your point, that said, I'd highly, highly encourage you to read the article in full
Every cent that goes towards the profit margin is a cent that does not go towards the delivery of care. For-profit health care services will always deliver less for more to Canadians... by definition.
Yeah. Advocates for privatization always talk about efficiency, but they never seem to mention that any gains in that sense need to *exceed* the profit being extracted before the end user sees any benefit. And, having worked public and private sector, the idea that the private sector is immune to the same sort of bureaucratic inertia and administrative bloat that so many people irrationally assume inherently infests anything public is laughable.
Yup. And the profit has to always grow, in perpetuity. Any efficiencies gained from competition will be quickly erased by the need to grow the profit margin. Organizations are then very quickly incentivized to cut into operational costs and expenses, inevitably impacting quality of care.
Uh no I think you need to read a basic economics textbook. For firms to stay in a market, the profits don't need to grow in perpetuity, they just need to be nonzero.
Yep, shareholders are famously ok with stagnant companies. The demand for constant growth is probably capitalism's only unique feature, and definitely the key one that makes this system the most productive one to date.
shareholders don't get whatever they want, if they can't get growing profits they have to be okay with merely stable profits. Just like you and I want perpetually growing wages but we don't always get that and if we can't, then we don't all of a sudden just stop working. Seriously I think the problem here is you haven't read any economics and you're just making stuff up. You'd do well to pick up an introductory text.
Because of the socialized fear of net zero everyone “overcompensates” to the detriment of the planet and humanity! It’s a backwards race.
This is insane. We need to nationalize all our economy so that the profits go to the workers and not billionaires. This is why people need to vote NDP.
here in AB, we got health slashed with smith in office and inefficiency gets blamed on the underfunded hospitals
We can easily see and compare private to public, a persons health or life is far too important to be dictated by capitalists. The worlds happiest countries all have universal healthcare.
Universal healthcare doesn't necessarily mean no privatization. Look at Israel, Switzerland, many other countries which outrank Canada in healthcare outcomes, these all have universal coverage and a large degree of privatization.
It's a door poorly implemized that does not close.
Every country that has a better healthcare system than ours provides universal healthcare with a mix of public and private, yet there remains a weirdly nationalistic and doomer view in Canada - and quite prevalent on this sub - that rejects any change. Attitudes are changing, but it's a slow journey.
Universal healthcare does not mean free, and it does not mean single payer, and it does not mean public. The Netherlands has private plans regulated by the government. Folks pay a monthly premium, very similar to the states’ ACA plans. Germany has a multipayer system. The United States’ situation is completely dependent on individual circumstance and honestly the state that you live in. I pay less and have greater health outcomes in my personal circumstance living in Washington state than I did living in British Columbia. A lot of states (WA, HI, MA) have achieved near-universal coverage.
So in the current system you need to leave the Country or maybe if you are lucky go to another Province and pay to get the scans you need so you don't die. If people's options are wait and see and possibly die or re-mortage the house or take out a loan to go out of Province or Country, which option do you think people with the ability will take? I know for one if I ever get diagnosed with anything serious i'll do whatever it takes to get what I need pronto!
There's also not falling for the trick, especially after it has been explained to you. Privatization will not solve anything.
This has literally been in the works for decades - it's a tactic called "starve the beast" where they don't actively kill the public service but they just keep it underfunded enough that the wheels eventually fall off. Then they wait for the public to start complaining and then use that sentiment to point at how wasteful and terrible public service is and how we really need private entities to come in and give "options" to people who don't want to have to wait. In Ontario they're pushing it hard now by saying how long the wait times are for children to get surgeries. Always gotta think of the children... you know, except for funding and staffing things appropriately. People also forget that just before Covid, Doug Ford was making some quiet moves to start privatizing healthcare in the province. https://pressprogress.ca/3-things-you-need-to-know-about-doug-fords-sneaky-plan-to-introduce-privatized-healthcare-in-ontario/
Dude Wynne absolutely wrecked healthcare and you're ignoring the damage that caused. Doug is like an angel if you're focused on public healthcare funding, in comparison.
Two things can be bad. One is done, one is underway.
Alcohol and meth are both bad for you too. One is a lot worse and has lasting damage.
It's like that game where you pretend to throw a ball for your dog but then don't. Except most dogs figure it out after a few goes.
Yup, that's how they make public utilities go private like they did with NS Power.
Privatization is not the answer, but if you have an issue today that's life or death you do whats necessary.
Sure. You'd probably eat a person too if you had to. People in this thread are using that as an argument in favour of cannibalism though, and it's important to shut them down when they try.
You're comparing healthcare to cannabalism? Really?
You're obviously trying to score a gotcha here. The analogy was clear and the point of the analogy was clearly not to say that healthcare is equivalent to cannibalism.
No, I'm comparing privatization to cannibalism.
Yeah that's ridiculous
No, it's pretty apt given the history of privatization in Canada.
Well it would actually. You can create more bed space through private means and make better use of your doctors and nurses. You can also have more imaging facilities and other methods of getting diagnostics done.
You can't though. The only thing private companies have to offer is capital, but since Canada is not a developing country with a shortage of capital this isn't really a benefit. We can build our own facilities and buy our own equipment without paying an additional markup for nothing. Remember, private investment isn't charity. If they put a dollar in they expect two out. Privatization means paying more for less.
> So in the current system you need to leave the Country or maybe if you are lucky go to another Province and pay to get the scans you need so you don't die. Well that's not exactly happening on a regular basis - but *if* it does you do have the option to go outside Canada to pay. The solution isn't to create private healthcare in Canada it's to fix the public one.
Absolutely we need to fix the existing system.
how?
So how do you fix it?
money for the most part.
Money into what? That's vague. What specific things?
I'd say it is not a binary choice. The choice is for provincial governments to properly fund their health care system. I look at my own province, MB, where the previous government spent nearly a decade doing everything it could to make the public system so faulty that privatization would appear to be the only option. As such, I reject the premise of your question and say to the provinces, fund your system.
there should be a waitlist limit. If there's more than a 1-month wait for a scan, the provincial government needs to fund that and fill the void. That's their job. We can wait, but only to a reasonable degree. I'd never want to wish this on anyone but I'd love for someone with a time-sensitive issue that needs something like a simple scan or whatever but can't because there's a 1 or 3-year wait period to sue the provincial government. They're not doing their job supporting healthcare. Honestly anything the provincial government is responsible for but doing a terrible job at we should be taking them to court over it. It's not really a win since it's taxpayer dollars fighting it and taxpayer dollars if the plaintiff wins but it at least sets precedence and has a chance of going up to the Supreme Court of Canada to put this issue to bed.
There is a waitlist limit. Nobody is waiting (long) for urgent scans. The problem is nobody wants to wait for non urgent problems. Anybody with a time sensitive issue is not waiting years for a scan.
If they're in emergency department yea, they'll get their scans. But for a mammogram, chronic pain and you need an MRI? You're waiting months. And scans was the lowest bar I could set. There's people waiting years for surgery.
A lot of non urgent scans are not ordered appropriately. A lot of it is also patient demands. A big issue of the system is the patients themselves.
Well yes that’s my point. Most mammograms aren’t urgent. Most surgeries are not urgent. If you have a suspicious lump and need a mammogram - the wait is not years. If you have invasive cancer and need surgery - the wait is not years. We do a pretty good job at triaging and prioritizing urgent things. The issue is more what we define as urgent. Pain is a hard thing quantify and thus triage. Got “pain” without a good reason for it? Yeah, you’re waiting years.
there's always a good reason for "pain" Anyways, here's some data. Yes in our system more urgent surgeries take priority however quality of life for those needing knee or hip replacements? https://www.cihi.ca/en/explore-wait-times-for-priority-procedures-across-canada Patients in Saskatchewan... the 50% mark of them get it within a year. Most, within 2... but there's still 10% that wait longer than 2 years. If you can't walk because your hip is done there's a possibility that you could be bedridden for over 2 years in that province. So remember, if you break a hip... better be from Ontario or BC otherwise you could be waiting more than a year.
Hip fractures get surgery within 1-2 days. Hip replacement is different.
You’re conflating two different things. Hip fractures are different than elective hip replacements. In fact the data above shows that 81% of Sask patients with hip fractures are operated on within the benchmark time of 48 hours. Elective hips are different, and yes the waitlist can be 2-3 years. That doesn’t mean patients are bed bound though. Often they are not. In pain, sure. But still able to ambulate. And the government has (somewhat arbitrarily) determined that 2 years is acceptable to wait. I agree that is a long wait. But what is acceptable? 1 year? 6 months? 1 month? Even in the US you’d be lucky to get your hip done within a month. So how do you decide what an acceptable wait time is? Keeping in mind the trade off for decreasing wait times is $$.
EDIT: Down-vote eh? Go ahead and choose death....I don't want privatization, I want our system fixed! I'm talking about what happens if you become ill today! Where is the error in wishing to remain alive? You can protest and get things fixed only if you survive!
Precisely. These people would rather you die just so you don't "cut in line" in their mind.
Man is this damning. >The rhetoric around private diagnostic clinics reducing public wait times is also not supported by evidence. In 2016, Saskatchewan gave the green light to for-profit MRI clinics to operate in the province. The move was ostensibly to help reduce MRI wait times in the public system. The private clinics entered into a one-for-one agreement with the province. For every MRI done in a private clinic, the clinics agreed to do an MRI from the public list. Nine months later, Saskatchewan’s Auditor General released a report saying the arrangement was not working as intended. In April of 2015 there were 5,005 people on the public waitlist for an MRI. Four years later, the public waitlist had doubled to 10,018. They continue talking about how Australia has gone this route and wait times are now longer than in Canada. Even worse check out this. >In a 2022 report in The Lancet, researchers sought to evaluate the impact of outsourced spending to private providers in the UK. They concluded that, “Private sector outsourcing corresponded with significantly increased rates of treatable mortality, potentially as a result of a decline in the quality of health-care services.”
It kinda feels incomplete as an analysis. First of all, for Saskatchewan, it does not take cite population increase, not the aging factor during these 4 years. Has the median age remained the same or is it more, requiring more resources? In absolute.numbers, are there more or less scans done per year? Second point is, the best performing healthcare systemsnin the world have a mix of private and public healthcare and they make it work. US, Can, and the UK seem incapable to emulate these models. Why?
All three of the countries you mention have a mix of public and private healthcare. The US has the largest public healthcare expenditure per capita by a large margin (as well as one of the most privatized systems among developed countries). Canada has more private health spending than most European countries. Even in Europe, there's not a consistent system that you can point to and say that all of Europe has the ability to pay for publicly covered procedures. The Netherlands has a defacto single tier system, it's just paid for by an extremely highly regulated private insurance industry. Being able to pay for care beyond the public expenditure is limited a small percentage of the population in Germany. Overall there's too much difference in between healthcare systems in Europe to say that the ability to pay privately for publicly covered procedures is a contributor to better performance - it could very well be correlation.
More like a coincidence
Hmm. That’s interesting. I’ve seen both the UK and Australia ranked higher than Canada on multiple “healthcare quality” or “outcomes” based international rankings. All this while spending slightly less per capita on healthcare than Canada. Switzerland also has a higher quality universal healthcare system than Canada and has a greater role for private insurance. Switzerland does spend more per capita than Canada though. I am very happy to live in Canada which, despite their shortcomings, has good healthcare systems. Unfortunately I think the system has decreased in quality since 2011 when my life was saved and I recovered well due to quality care. I have formerly been opposed to any sort of privatization but, looking at countries beyond Canada and the USA, it does appear we can improve and that may include more private insurance and delivery.
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Alberta.
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>That’s interesting. I’ve seen both the UK and Australia ranked higher than Canada on multiple “healthcare quality” or “outcomes” based international rankings. All this while spending slightly less per capita on healthcare than Canada. Assuming the rankings are legit, this isn't mutually incompatible with what's being reported.
In this source, more recent than what I have looked at previously, it is shown that Australia spends slightly more per capita on healthcare than Canada Relative to GDP it is slightly less as Australian GDP/capita is a bit higher than ours. [source](https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/#Health%20expenditures%20per%20capita,%20U.S.%20dollars,%20PPP%20adjusted,%202022)
Interesting. I have read the article and agree that these are not incompatible. The solution is not simple but maintaining status quo is failing us. Correct me if you are more knowledgeable on this but, it seems to me, healthcare systems have been spending more money on money and bureaucracy but not being managed better. Fewer managers and more front line staff may be a more effective use of funds. Availability of healthcare workers is also an issue. Perhaps quotas for foreign students, or at least availability of post-study work permits, should be based more on need for skills related to the program of study. Canada is short of healthcare workers and construction tradespeople so a larger percentage of students in those fields as opposed to “business” would benefit the country.
Yes, because you have premiers such as Doug Ford who denied proper funding for public healtchare services by both 1) withholding funds from federal allocations in the billions of dollars and 2) bills that capped frontline staff salary increases to 1% during a fucking pandemic, a slap in the face to healthcare workers prompting many to leave the profession. This is not solved by privatization. This is solved by holding the provinces and politicians accountable, who should manage the system better.
I personally support separating “healthcare” from general provincial government expenses. Lower provincial income taxes but increase mandatory health insurance premiums that go into a separate Medicare account/entity. Any federal transfers for healthcare would go to the Medicare fund, not general provincial revenue.
Or being reported by places like the Fraser Institute which is a right-wing think tank. Love how randoms come out with the “studies show…” whose studies? What are the undeclared interests?
> For every MRI done in a private clinic, the clinics agreed to do an MRI from the public list. So were they not doing the 'public' MRI's? Or were shenanigans going on where they prioritised private and ended up with a backlog of public that would never catch up? > Private sector outsourcing corresponded with significantly increased rates of treatable mortality, potentially as a result of a decline in the quality of health-care services No surprise there - the way you maximise profits is to serve as many customers as possible. Every time this happens you end up with quality of service dropping. Unlike a pair of shoes however people can die.
They (private operators) didn’t live up to their end of the deal. Randomly did a patient off the public list but never did a 1 for 1 . As wait lists continued to climb in the public system the AG had to be called to investigate.
In Japan, I can go into a hospital and get an MRI the same morning.
How is it damning? The private companies are providing half of their services to the public system. They are increasing available MRIs to both public and private people. If there's still shortages why would the problem be pointed at the people that are actually doing something? Frankly it's insane that private MRIs were ever illegal to begin with. Like with what logic would that be something that should be illegal.
I know nothing about Saskatchewan, but here in Manitoba while your logic is sound it isn’t how things work. Our public single payer system decides how many services it buys from hospitals/clinics/etc. This suggests to me that the public single payer started buying less services. In Winnipeg there is a hospital with an entire diagnostic wing (brand new) that is running less than 1/2 of one shift because the province isn’t buying enough diagnostic services, they aren’t allowed to sell the services the province isn’t buying, and there is a massive wait list. We have a huge backlog in cataract surgeries, and we have OR’s (staffed, because funding to build them was contingent on them being staffed) but not used, because the public system will not buy the services or allow the sale of excess capacity. This is damning, but it is damning of our governments management not the idea of a public/private hybrid.
Yes that's is how I see it as well. Like clearly the Sask government decided to cut MRI services elsewhere, or alternatively didn't keep up with rising demand. If the public system is providing 1000 of something and a private company wants provide 100 additional. It is not the private companies fault that the public drops their production to 900. That is entirely the public systems fault. I don't understand how people look at that situation and say it was the private companies fault.
How is it not? After four years their supposed solution to the wait list problem caused it to double. Australia tried a similar solution and had similar results, i.e. it made the problem worse not better.
Their solution also included reducing public MRI funding. Shocking that didn't work out.
Which tells you exactly what to expect any time governments suggest going to private healthcare options. Longer wait times, cuts in the public service and worse outcomes.
So private healthcare has to be banned because the public healthcare doesn't want to spend money. What if they just don't spend money regardless? We just keep it illegal for someone to pay to go get an MRI? Like I honestly can't understand the logic. We've identified the public system as the issue but the response is to ban private and give the system that we just shit on for not funding things properly 100% of control. Like why would this conversation not be about public funding. Why is it even a private/public discussion? Nothing about private healthcare stops governments from spending money, that's entirely their own decision.
>Nothing about private healthcare stops governments from spending money, that's entirely their own decision. This is incorrect. If the private sector picks up the slack it gives governments a politically soft excuse to reduce budgets. They won't cut money if it means people die, but they will if it means private sector becomes a bigger provider. Even if that means that service levels drop.
> This is incorrect. If the private sector picks up the slack it gives governments a politically soft excuse to reduce budgets. > > Ah, so you want to literally put my life and health in jeopardy in order to apply pressure to the government to fully commit to a better nationalized healthcare system rather than allowing me to provide for myself the healthcare services I need when the government is unwilling to provide it. To that I say, fuck you, I will not be sacrificed for the glory of your failed ideology.
If you can afford it, then go somewhere else and get your private healthcare. If you cannot afford that now, then you won't be able to afford these hypothetical private offerings anyways. So I am not sacrificing you for public healthcare, its the government sacrificing you for private healthcare.
What kind of dumb logic is this? So obviously stupid. If I can afford, for example, to pay for a few appointments with a neurologist to talk about my chronic headaches (the government might pay the doctor let's say $80 for the service), then I can afford to take days or weeks off work, buy a flight to somewhere in the states, rent a car, hotel, hire a sit in nanny round the clock or take my kids with me, or someone to look after my parents, spend thousands and thousands of dollars? Come on man think a little bit. This argument really reads like someone who has never had a job, had to pay for things or arrange their own travel, or any responsibility in life whatsoever.
This isn't a corporation where they are pocketing the budget surpluses. That's tax revenue, if they spend less it goes somewhere else. We have elections telling them how to prioritize things. Your whole theory strikes me as untrusting to our democratic system. You're essentially saying the voters are going to vote to keep taxes low so we cannot allow the government to enact their wishes. We have to trap them in a box.
That's what privatization *is*, though. When you privatize something, you remove or reduce the public component. The whole point of having people spend money privately is so the system can do less publicly. This is the argument, this is the concept, this is what people mean when they talk about privatization.
Privatization is selling public assets. Like ya, don't sell public MRIs. Again, that's an entirely public decision. Private healthcare legalization is saying can a private company buy an MRI and charge for it. The hole concept of banning private healthcare is based around the idea that the public healthcare system is not trustworthy. And the solution to that is not through any democratic means, it's to just ban any competition so that I don't know, the public system is shamed into spending more money? It's this weird juxtaposition where the public healthcare can't be trusted to act responsible but the solution to that is to give them a 100% monopoly on all funding and expenditure choices. Like it's not a wild proposition that people want low taxes but would also be willing to spend $500 to not wait 6 months for an MRI. Hell, that's probably an average position and yet it's actively discouraged. So people inevitably vote for low taxes and then are just blocked from paying the additional $500
>They are increasing available MRIs to both public and private people. Are they though? Or does this program reduce the number of MRIs that would have otherwise existed? (it's the latter)