Wow, sure alot of horse caca flying around this thread. Let's get back on track.
The crux of the question being debated here is whether "more money" is the solution to a strained health care system.
I've argued "no" and I firmly believe that the Health Act has to be reorganized.
I'll respond to some of the points I noticed following my earlier comments.
I don't think hospital cleaners will be sterilizing operating equipment, so that is a red herring.
Caesar
But I also don't want to see private enterprise manage it without any accountability to the tax payer.
Nor do I. As I shall argue, the MSA removes the notion of "tax-payer" from the equation and puts the decisions of health care firmly in the hands of the patient, who is backed up by a system of universal coverage for catastrophe and manages their own incidental needs (which are nickel and diming the system to death) on their own.
I don't want to see a system where the government is involved in the day-to-day running of hospitals, or other care facilities. To my knowledge they don't do that now anyway. Doctor's offices are already private, but they are funded and regulated by the gov. Simply put, they are free to make money (obviously), but cannot do whatever they want, or charge what they want.
They operate under global budgets which force them to make choices (many which involve perverse incentives) tied not to the health of a patient, but to the fickle nature of the budget. I'd advise you to look at Grazer's book to see how messy health care budget decisions get once it hits that level.
The problem is funding. The government provides this funding, and if there isn't enough money to do all of the procedures that need to be done, a waiting list is created. I think the gov funds each 'Health Authority' separately, and it's the regional health authorities that determine how and where the money is spent.
In many cases problems arise when doctors are constricted in their ability to practice due to, you guessed it, budgetary concerns. Doctors are limited in the actions they take and the clients they see by the government managed budget. You are put on a waiting list due to the fact that some bureaucrat has decided that "X dollars and Y amount of patients will be seen today"; centralized decision making inhibits the ability of hospitals to make decisions based on the needs of their patients.
Conversely, I definitely don't want a system where the government simply funds the system but private enterprise decides how to spend it. I don't want to give private companies (whose sole objective is making money) a blank cheque with no system of accountability to the tax payer.
That is why I've advocated a the MSA system (read my other thread). You, the citizen and patient, do not require the government to hold accountable a private practice due to the fact that you manage your (daily health care costs) health care costs.
As well, you assume that the sole objective of the private market is to "make money". I would urge you not to adopt such an extreme position. I would like to believe that private business also has an interest in providing a service to the community. My family owns a hotel, and we are not only "driven to make money"; we keep the costs low so we can make a living at it (which we've done for 25 years), we keep the prices low to attract customers, and we go out of our way to ensure our customers are satisfied, because a poor reputation is disaster in the private industry.
I would think a hospital would be no different. If people managed their own funds through an MSA, and hospitals existed only "to make money" at the cost of efficient and effective health care for the patients, wouldn't you think that their market (ie customers) would dry up pretty quick and be replaced by someone who is willing to deliver health care in a better way? It is that "invisible hand" thing....
Bruce Monkhouse
What you forget is they save money by undercutting the quality and if necessary the quantity of care you will receive.
That is baloney. We didn't save money in our Hotel business by firing the Chambermaids and closing down half of our hotel rooms. We innovated and adapted until we found something that worked right (in our case, new good managers and a new business draw for customers). If people are held accountable for their own health care funds (as in an MSA), poor health care delivery will be starkly evident when the waiting room is empty. With a perverse consumer/provider relationship in a government run system, the ability of the Health Care industry to adapt and change according to the needs of the patients just isn't there.
I believe that we will find big savings through the elimination of big government bureaucracies that exist to determine how Canadians should manage their own health and the elimination of big Public Sector Unions that constantly hold the government (and by extention, the public) hostage with outrageous demands.
That and the fact they will simply turn tail and leave if the profit margin isn't there and then your left with the same need and no one who really knows how it works.
On this point I do agree with a part of the thrust of your argument. I would not want to see the government suddenly say "You are all private, go". It would need to be a structured move. If the market is not strong enough to support private practices in certain areas, the government should provide services in order to cover basic health needs (ie: a local practice and/or emergency capabilities to transport people easily to larger facilities). If private industry proves to provide better and more efficient health service to an area, the need for government intervention is non-existent and the publically funded services can be reduced.
What is required is better public money managers.
Thanks but no thanks, haven't really seen such a thing yet, most likely due to the fact that any sense of fiduciary responsibility seems to fade the further away the "public money manager" is from the source of the money he manages (ie: the tax dollars of your labour). I can manage my own health care (and my own finances).
All those who think about less wages being the answer to health care funding, remember, you pay peanuts, you get monkeys........... monkeys looking after your surgery.
The Fraser Institute wage study only refers to hospital jobs that had a direct equivalent to the unionized Hotel Industry. It does not pertain to employees in the Health Care sector that possess specialized training and deal directly with patient needs; these people deserve the higher wages they earn due to the fact that they've educated themselves and they preform a vital service. In no place did I argue that we should pay Nurses, X-ray Techs, or Doctors less money (if anything, they need more).
Caesar (again)
Fiscal irresponsibility (in government) is something we have allowed to happen, but it's not something that has to continue.
It is my opinion that bureaucracies possess an innate characteristic of bungling public funds; to disprove my idea please find me a well run, efficient and effective government bureaucracy that leaves the Canadian taxpayers satisfied.
Moving away from these fundamentally unsound organizations seems to be the necessary step; you can't change the beast. Of course, this is only my opinion, so feel free to shoot it down if you think it is based upon faulty logic.
A public system's priority should be quality of care first, financial responsibility a close second. A private systems priorities will be profit, with no real secondary priorities. Saving my tax dollars is definitely not even a consideration to the private entrepreneur, nor do I think it should be.
I've argued above that this analysis of the private market is unfair and unrealistic. A private entrepreneur wouldn't be concerned with "saving your tax dollars" in an MSA system; he would be concerned with delivering a profitable service to the community (which means it must be efficient and effective or he will go broke).
Bruce Monkhouse (again)
Maybe because that cleaner is also cleaning the same area where your innards might be exposed to some of the nasty things that breed in a less than sterile enviroment.
I don't think unskilled janitors are going to be sterilizing operation equipment, so that argument is a red herring as well; these are people who sweep the floor, take out the garbage, clean the bathrooms, etc. The Fraser Institute is keen to compare these employees to their counterparts in the Hotel Industry; both Hospitals and Hotels depend on clean facilities in order to keep customers (guests or patients) happy. So why is it that the Public Sector cleaners deserve 3 dollars more an hour? The Hotels pay an acceptable and reasonable wage to their (unionized) employees in return for services provided (ie: nothing too specialized), and I don't see every hotel in Vancouver turning into an East Hastings crackhouse.
I don't consider 12 bucks an hour a" livlihood", thats a job you do untill you land the" real one"
No, but does this mean that we get inferior services from the person because they are not a professional "health care facility maintainer". Should we encourage people to consider their sole source of income to be the night shift at the local hospital by giving them an unusually high wage for the services they provide? I believe in paying people a reasonable wage for their labour. Obviously, if their labour is dangerous or more specialized (soldier or chemist), then they deserve more as opposed to someone who does the same thing as a pimply-faced 15 year old at McDonalds.
