Two-Tiered Health Care
The other day I was standing in the emergency ward of the tiny Montfort hospital and was appalled at what I saw before me. Not only were the beds all full, but the beds were so full that an elderly man on a ventilator was shoveled off to some hallway, strapped like a psych ward patient to his ambulance cart. They were waiting for a bed somewhere to open up. Apparently they didn't even have room for an 80-year old who couldn't breathe with his own lungs.
At first I thought the problem was simply a shortage of beds, but as I walked around and explored I realized that both the rooms and hallways were already crowded with beds, all of them full. There just wasn't any space left to fit more beds! I'd say about 95% of these patients were elderly, many of them probably at risk for heart attacks or other heart complications. These are people who desperately need the care, and there isn't room for them.
And of course they don't get proper attention devoted to them. At night there are maybe 2 doctors on staff in the whole emergency ward, only a handful of nurses, and a few administrative staff. The overnight staff are no doubt tired and busy with tests, paperwork, and other things. Monitors are beeping all over the place, and are typically ignored because more often than not wires become unattached or machines malfunction. Many patients are forced to wait overnight to see specialists coming in in the mornings, many of whom come in late or only work odd days of the week. These people are frail and not in the best of health, no doubt scared for their lives. I suppose some treatment is better than no treatment, but as a first-class country is this something we can really pride ourselves on? I think not.
And this is a normal day. It probably gets a lot worse. I'm told on average this hospital alone gets 3 cardiac arrests a day. Add to that injuries and car accidents, strokes, alcohol/drug poisoning, and you have a lot of people who need immediate care!
Something needs to be done about this. We've been talking about health care reform for over a decade. Everyone knows the hospital line-ups are too long, that elderly people are crippled waiting months to a year to get a simple hip replacement, that specialists are impossible to book appointments with and both doctors and nurses alike are in severe shortage. We can barely sustain reasonable health care for the population we have now, and with our aging population, in 5-10 years the health care system will be completely overflown. And that doesn't even take into account the obesity epidemic. Obesity is a known leading cause of all forms of chronic disease from cancer to heart disease to diabetes. With obesity rates soaring as they are, incidence of adult onset diabetes will soar to 3 million by 2010. That's 3 years away! And they're already predicting 4/5 of these patients will die of heart disease.
Drastic times call from drastic measures. But what exactly are we going to do about this? We need more doctors. We need more nurses. But most importantly, we need more hospitals! We need more space to deal with the growing demand on the health care system! (and then of course we need the people to staff them)
A quick fix to the doctor shortage is to recognize degrees from foreign countries and allow immigrant doctors to practice medicine here. Jack Layton probably sprinkles that all over his tofu for breakfast. But having more doctors alone isn't going to solve the space issues. Real health reform is going to cost a lot of money! And where could this money come from?
Admittedly the government is not poor. If you look at the amount they waste on excesses it is clearly hypothetically possible to finance the sort of health care system we require in the upcoming years. But good luck tackling corruption. Political corruption has been around for millennia and is not going anywhere any time soon. If you want to try to clean up all the waste in the bureaucracy and turn our nation into a police state where everyone is forced to be ethical by threat of capital punishment, then so be it. Yelling at the government to be more accountable about their spending isn't going to fix anything. They have the money, and the power, and they know how not to use it.
Perhaps we could raise taxes? But people are already bitching about the GST. The same GST that is almost solely responsible for all our debt reduction and digging our government out of a deficit. Regardless, people seem to want nothing more than to abolish it. So more sales tax seems out of the question. Could we raise income taxes? The middle and upper tax brackets are already looking at tax rates around 50%, significantly higher than in the US. It's a miracle they haven't moved south and become millionaires. We can't afford to lose them because the government largely relies on their taxes and the stability of the economy relies largely on their spending habits. Perhaps we could raise corporate taxes, but then we'd lose local investment fast and the economy would suffer dramatically.
So what about private hospitals? What's really so bad about them?
"No, not two-tiered health care!!! Anything but that! I don't really know what it means, but it sounds very American and I hate Bush. The US sucks!! Oh, and while I'm at the nonsensical conservative-bashing, Stephen Harper eats babies!"
Ok, I admit that is so much of a straw man that it is probably going to break out in song and dance and start skipping down a yellow-brick road, but sadly that actually sums up most of the opposition I have heard to 2-tiered health care. If you have more rational complaints, I'd like to hear them.
It's not like any funding would be taken away from Medicare. We'd still have the same services available for the general population. We'd still have free medical coverage in good hospitals! Meanwhile, allowing private companies to open hospitals relieves a huge burden off the public system. People who have money but not patience can get the service they want without the unseemly waits. And then others will also have shorter waits because the public hospitals will be less crowded. You can put incentives in place to keep good doctors at public hospitals so quality doesn't suffer significantly.
To me the demographic that would benefit from this the most would be the elderly. People who have lots of money sitting away in retirement savings but would much rather spend it on improving the quality of what's left of their lives than keeping it in a bank. Let them pay for better service and give them the dignity of the proper health care they deserve living in Canada!
At first I thought the problem was simply a shortage of beds, but as I walked around and explored I realized that both the rooms and hallways were already crowded with beds, all of them full. There just wasn't any space left to fit more beds! I'd say about 95% of these patients were elderly, many of them probably at risk for heart attacks or other heart complications. These are people who desperately need the care, and there isn't room for them.
And of course they don't get proper attention devoted to them. At night there are maybe 2 doctors on staff in the whole emergency ward, only a handful of nurses, and a few administrative staff. The overnight staff are no doubt tired and busy with tests, paperwork, and other things. Monitors are beeping all over the place, and are typically ignored because more often than not wires become unattached or machines malfunction. Many patients are forced to wait overnight to see specialists coming in in the mornings, many of whom come in late or only work odd days of the week. These people are frail and not in the best of health, no doubt scared for their lives. I suppose some treatment is better than no treatment, but as a first-class country is this something we can really pride ourselves on? I think not.
And this is a normal day. It probably gets a lot worse. I'm told on average this hospital alone gets 3 cardiac arrests a day. Add to that injuries and car accidents, strokes, alcohol/drug poisoning, and you have a lot of people who need immediate care!
Something needs to be done about this. We've been talking about health care reform for over a decade. Everyone knows the hospital line-ups are too long, that elderly people are crippled waiting months to a year to get a simple hip replacement, that specialists are impossible to book appointments with and both doctors and nurses alike are in severe shortage. We can barely sustain reasonable health care for the population we have now, and with our aging population, in 5-10 years the health care system will be completely overflown. And that doesn't even take into account the obesity epidemic. Obesity is a known leading cause of all forms of chronic disease from cancer to heart disease to diabetes. With obesity rates soaring as they are, incidence of adult onset diabetes will soar to 3 million by 2010. That's 3 years away! And they're already predicting 4/5 of these patients will die of heart disease.
Drastic times call from drastic measures. But what exactly are we going to do about this? We need more doctors. We need more nurses. But most importantly, we need more hospitals! We need more space to deal with the growing demand on the health care system! (and then of course we need the people to staff them)
A quick fix to the doctor shortage is to recognize degrees from foreign countries and allow immigrant doctors to practice medicine here. Jack Layton probably sprinkles that all over his tofu for breakfast. But having more doctors alone isn't going to solve the space issues. Real health reform is going to cost a lot of money! And where could this money come from?
Admittedly the government is not poor. If you look at the amount they waste on excesses it is clearly hypothetically possible to finance the sort of health care system we require in the upcoming years. But good luck tackling corruption. Political corruption has been around for millennia and is not going anywhere any time soon. If you want to try to clean up all the waste in the bureaucracy and turn our nation into a police state where everyone is forced to be ethical by threat of capital punishment, then so be it. Yelling at the government to be more accountable about their spending isn't going to fix anything. They have the money, and the power, and they know how not to use it.
Perhaps we could raise taxes? But people are already bitching about the GST. The same GST that is almost solely responsible for all our debt reduction and digging our government out of a deficit. Regardless, people seem to want nothing more than to abolish it. So more sales tax seems out of the question. Could we raise income taxes? The middle and upper tax brackets are already looking at tax rates around 50%, significantly higher than in the US. It's a miracle they haven't moved south and become millionaires. We can't afford to lose them because the government largely relies on their taxes and the stability of the economy relies largely on their spending habits. Perhaps we could raise corporate taxes, but then we'd lose local investment fast and the economy would suffer dramatically.
So what about private hospitals? What's really so bad about them?
"No, not two-tiered health care!!! Anything but that! I don't really know what it means, but it sounds very American and I hate Bush. The US sucks!! Oh, and while I'm at the nonsensical conservative-bashing, Stephen Harper eats babies!"
Ok, I admit that is so much of a straw man that it is probably going to break out in song and dance and start skipping down a yellow-brick road, but sadly that actually sums up most of the opposition I have heard to 2-tiered health care. If you have more rational complaints, I'd like to hear them.
It's not like any funding would be taken away from Medicare. We'd still have the same services available for the general population. We'd still have free medical coverage in good hospitals! Meanwhile, allowing private companies to open hospitals relieves a huge burden off the public system. People who have money but not patience can get the service they want without the unseemly waits. And then others will also have shorter waits because the public hospitals will be less crowded. You can put incentives in place to keep good doctors at public hospitals so quality doesn't suffer significantly.
To me the demographic that would benefit from this the most would be the elderly. People who have lots of money sitting away in retirement savings but would much rather spend it on improving the quality of what's left of their lives than keeping it in a bank. Let them pay for better service and give them the dignity of the proper health care they deserve living in Canada!