Friday, 27 October 2006

Evaluating Harper: patient wait times

Part five in my evaluation of the Harper government, Conservative priority number five: working with the provinces to establish a Patient Wait Times Guarantee.

Hmm, this won't take too long to comment on. Even the Conservatives are not pretending they have accomplished this yet and wait times have actually lengthened ever so slightly since they have been in office.

Of course, it is always a very tricky thing for the federal government to wade into the whole health care issue, seeing as that is provincial jurisdiction. Unfortunately, that doesn't stop voters from blaming the feds for whatever is happening in health care, so Ottawa is politically obliged to make appropriate noises. Seeing as they do actually contribute to provincial budgets, they have to try to leverage that influence in such a way as to impress voters without enraging provincial governments. It's not surprising that this was the last of their five priorities, as it will probably be the most difficult to implement. I don't know if they'll get a chance to try before the next election.

I'd be somewhat tempted to throw rocks at them for even making promises in this area, but really, this is a case of voters getting what they deserve. We shouldn't be holding the federal government accountable for something under provincial jurisdiction, but we do. This is pretty much a no-win situation for any party.

Havings said that, I would dearly love to see some new dialogue in the whole area of health care in Canada. It is time to start thinking outside the box and getting past old orthodoxies here. I am heartily sick of the "American system" red herring waved around with great mock indignation at every election. Every time a (Conservative) politician makes the obvious observation that we have problems with our health care system, the Liberals and NDP trot out the same hysteria. And it's a (I'm trying to think of a polite way to express this, as I am basically a polite person, but it is truly challenging...) um, logical fallacy. We are not restricted to two choices and two choices only. There are other things in the world besides the Canadian and American systems and even if there weren't, we could invent something new. It's time to get our heads out of the sand and start questioning the way we do things. This is going to be very difficult with so many different players, but somebody should start. This probably would fall to a province with some guts - probably Alberta - to just strike out and do something different and demonstrate that it can work. Alberta is the best candidate, first because they have never felt obliged to kowtow to Ottawa or the other provinces and second, because they have the budget to pull it off without help.

As far as Harper's government is concerned, I'll let them off with a neutral mark. Something to the effect of "not evaluated this term", like I have seen occasionally on my kids' report cards. There is only so much you can expect from a minority government in less than a year. In the somewhat unlikely event that we still have the same government a year from now, I will be less accomodating.

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Tully said...

Japan manages to supply fairly decent health care to their entire population for half or less the %GDP cost of US health care. They have some of the same problems with their system that Canada does.

There's no perfect system, of course. But if you can get around the bureaucrats and power players there is always room for improvement.

Janet said...

Tully, sometimes what you have to get around is the voters and the politicians. Self-righteous politicos in Canada wrap themselves in the flag and excoriate the American system, and far too many Americans, mostly Republican, recoil in horror from the evils of socialized medicine.

It's all ridiculous. We do some things better in Canada. Ask any poor American who has fallen between the stools of Medicaid and workplace medical insurance if he wouldn't rather have a Canadian system and he'd jump at the chance. On the other hand, wealthy Canadians will often go south of the border to get faster care, because they can afford it. You do some things better in the States.

We should stop tying these things into our sense of national identity, check out the Asian, Australian and European models and figure out how to safeguard our strengths while compensating for our weaknesses. But so few people want to be rational about it. They're too busy defending orthodoxies and locking us into the past. And as far as I can see, this is happening on both sides of the border, to some degree or another.

SadButTrue said...

Your statement that there are more ways to accomplish health care than the US and Canadian options is right on the money. One problem we have in Canada is a chronic shortage of doctors in a large number of communities. This problem is perpetuated by the physicians themselves, who seem to want to keep the sacred priesthood status of their profession.
How about creating a 'second tier' of professionals, para-medicos with a status somewhere between that of current nurses and doctors. They could diagnose and treat the scrapes, bruises, broken bones and strep infections that comprise 90% of the industry's workload. This should be considered a priority with Canadian and US demographics being what they are.


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