There have been a rash of studies recently that attempt to tell us why healthcare is out of control in Canada and what measures are needed to reform the system. But these studies are not done by medical persons, they are the work of accountants and economists. In their world everything boils down to money. Social conscience and logistics be damned... their only metric is cash. So sad.
A recent study was from the MacDonald Laurier Institute. Their Director of Research, Jason Clemens, a well written author of studies on everything from banking to entrepreneurship and former Fellow at the Fraser Institute, reaches back to the welfare reforms of the 1990s to come up with three gems that will "fix" our healthcare system. The basis of his argument is in the statistics he presents. He tells us that of the top countries who provide universal healthcare, Canada ranks number five. (How many countries are there? He does not say.) He then tells us that in the 34 OECD counties (not just those providing universal healthcare) Canada ranks 26th in access to physicians, 16th in nurses, 24th in hospitals beds, and 16th in access in to MRI and CT scanners. An interesting statistic would have been to include the per capita cost of all healthcare spending per country, but I guess that is not important?
His fixes? Let's discuss them in order.
1.
The Canada Health Transfer should be stabilized or even reduced, and certainly not increased, in order to bring more direct accountability to the provincial level for the raising of resources used in healthcare while containing cost increases to the federal government.
In this fix, Clemens is saying that Healthcare is a provincial responsibility so the feds should get out of the picture. I agree with him, as I stated in my book,
The Provinces Must Go, a tome much hated by the political class cause it does them out of jobs. But knowing that the feds will not give up the revenue they use for the CHT, this can only mean more taxes on Canadians.
2.
The federal government should allow the provinces the maximum amount of flexibility to design, regulate, and provide healthcare to citizens within a universal and portable framework.
Anyone who reads the newspaper at least once per week knows that the healthcare changes that are being sought in Alberta are
privatization without regulation. Since that is not within the universal and portable framework, I cannot see what Clemens is suggesting here. Privatization without regulation within the framework is a fancy way of saying,
we own and you pay.
3.
The Canada Health Act will have to be amended with respect to cost-sharing and extra billing in order to provide the provinces the requisite amount of flexibility while maintaining and safeguarding the principles of universality, portability, and accessibility. Indeed, the federal government could facilitate provincial innovation and experimentation by clarifying the meaning and intent of the five principles of the Canada Health Act.
Since Clemens is using the 1990s welfare reform model as his base, let's look at them to discuss this fix. Ontario's Premier Mike Harris introduced Workfare as his reform measure. The idea was that if you wanted welfare, you had to work for it. Seemed a bit odd at the time. If you could work for your welfare, it meant that you could work... and there was work for you to do. So why be on welfare? But then the fecal material hit the rotating device. What about disabled persons? What about single mothers with kids not in schools? What about... What about...? And on it went. Turns out it was more difficult to carry out the program than the accountants and economists thought. Too bad they had not discussed the program with social workers or the welfare recipients before hand. It that what Clemens is suggesting?
At the end of his study Clemens makes the following statements: "
Canada’s national finances are in a precarious state. We face immediate challenges in the form of deficits and rising debt, as well as longer-term problems emanating from ever-increasing healthcare spending. We need to confront these problems with specific solutions. Using the lessons of welfare reform from the 1990s is the key."
The nation's finances are in bad shape so let's screw up the healthcare system to fix it? The $50 million that was spend on gazebos in Tony Clements riding could have been used to raise the nurse/Canadian ratio. The $9-15 billion that is to be squandered on F35 jets, with no compelling need for them, could buy more MRIs and CT scanners and still have money left over to certify more doctors.
It is time that the economists took a vacation and left the healthcare system to healthcare professionals. I wonder if there is room for me at the Occupy camps?
