Two-Tiered Health Care

[pandamao]

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

Comments

[pandamao]

Many immigrant doctors are already working in our hospitals - mainly, the ones from accredited schools. So steps are being made in this direction. There are a lot of second-rate Universities in India that give away MDs and PhDs like candy. The people working in cabs who claim to have PhDs are either full of shit or have degrees from these lesser schools. Most educated Indians will tell you that because they know the BS that goes on back in the homeland (watch some Russell Peters). I'm sure that applies to certain other countries as well.

I think I did misunderstand your use of "efficiency". Generally when there is a long line for something and people complain for the service to be more efficient, the idea is to move through the line more quickly so people don't wait as long. Clearly that is a bad idea.

As for managing funds more effectively, the primary cause of financial mismanagement is the fact that it is a public service. The government is TERRIBLE about managing money. Why wouldn't it be? The only things keeping it in check are people bitching. A business has to be accountable to shareholders and a board of directors. A business has to produce clear profit margins and compete with others. Subsequently anything private-run will not have the wastes that a public system does. Selling existing hospitals to the private sector (as was done with utilities recently) is perhaps the most effective way to reduce inefficient management and spending.

I respect how you are against a two-tiered society. However, you attend University, do you not? That is a luxury 99% of the world cannot afford or get into one way or another. Even in Canada only privileged people get a University education. The cheaper equivalent would be college. So you are paying more for a better service because you want something better for yourself than what is available for free - that is exactly the mentality behind any two-tiered system. I am not trying to call you a sellout, but merely pointing out that sometimes people want to pay more for a better service and should have the right to obtain that service.

The fixed quota of knee replacements is probably based on other factors.. like availability of equipment, surgeons, bed space, etc. In a private system, the service meets the demands and needs of the public. That is how business works. So if in one year more people need knee surgery, the business will find a way to accommodate for that. It is only in a public system where you impose arbitrary quotas to meet the ridiculous budget requirements imposed on you.

Mathematically, if you have 500 people waiting in line, and even 3 of them are rich and up and leave, then the line shrinks to 497. 497 is smaller than 500. Maybe in practice to an observer the 497 would look like it was still 500, and so the person would feel hopeless and think the situation has not improved. However, that is still 3 less people in the line! It is less of a burden. I make no claims to how great a degree the burden is relieved, but when some people actively choose to attend a private hospital rather than a public one, clearly you are relieving some burden from the public one.

Rich people are people too. Maybe they seem less human. Maybe people see them less often because they are hiding in their vaults of money. But they exist. The upper tax bracket in Canada represents over 10% of the population. This is not a majority, but it is not a select few elite either. Private hospitals in the US do not only service millionaires. You can get simple service at these institutions for maybe a few hundred. Simpler surgeries would be maybe in the 4 digit range. A lot of people in Canada can afford that if it means getting service with a specialist NOW instead of in a year. This is not just the fabulously wealthy, but a significant portion of the population that would benefit in some way.

I'd say opening the avenue to private health care is one step towards a solution. It is better than stagnating and doing nothing (what we are doing now). If funding for public health care remains fixed and incentives are put in place to prevent doctors from leaving the public sector, then how exactly will quality of service for poor people suffer? It should remain the same as it is now.