[Newsbot]

Filibuster Cartoons
Title: Health care growth (click to view)
Date: December 26, 2010
The bean counters over at International Monetary Fund have released their traditional batch of predictions for next year's global economy, with Canada's forecast being a bit of a mixed bag.

On the one hand, Canada continues to enjoy praise for its comparatively stable banking industry and housing market, low interest rates, and efficient stimulus spending. On the other hand, the country continues to face strong criticism for its incredibly high rates of personal debt, which are the single worst in the western world, and the ballooning costs of some of its social programs.

On the latter front, the IMF particularly singled out the Canadian health care system as an unsustainable ticking time-bomb of unsustainable expenditures. Many provinces are now devoting close to 50% of their budgets to health care-related spending, at a cost of around $5,500 per citizen, per year. Such costs, likewise, only go in one direction. Almost all charts relating to Canadian health care costs look identical, which is to say, a huge diagonal line climbing ever rightward.

In contrast to the IMF, however, Canadians are not generally bothered by such data, which they have been told by generations of political leaders is really no big deal. This isn't because the politicians have some secret plan to reverse the trends and bring costs under control before they bankrupt the country, mind you, but rather because they've found "defending health care" against any change to be a remarkably useful political talking point to rile up voters. "Free" health care has long been one of Canada's most cherished national myths, with the childish economic ignorance needed to sustain such a belief one of Canadians' least attractive qualities.

The IMF would like to see 2011 be a year in which Canadian politicians actually speak to their citizenry in an open and honest fashion about the long-term costs and consequences of maintaining this sacred cow, and bring in some of the private-sector reforms that will be necessary if we are to slowly shift some of the weight of the nation's health burden off of the crippled back of the state.

What a cute idea.

[andyt]

Actually, in BC, health care expenditures have remained almost constant as a percentage of GDP. What's changed is that spending on other things has dropped, so health care becomes a bigger portion of the budget. Methinks we're being fed a lot of bs by the gnomes of the IMF, who are all free market liberals. Thru the IMF, nations that are bankrupted by the banks are forced to take austerity measures that force ordinary working men and women to pay back what the bankers lost.

[JJ]

andyt wrote:

Actually, in BC, health care expenditures have remained almost constant as a percentage of GDP. What's changed is that spending on other things has dropped, so health care becomes a bigger portion of the budget.

But that's part of the point. As health care costs and spending rise, the provincial governments are forced to provide fewer and fewer other services, in order to divert more resources to health care. Provincial governments are slowly evolving into single-service entities.

[andyt]

JJ wrote:

andyt wrote:

Actually, in BC, health care expenditures have remained almost constant as a percentage of GDP. What's changed is that spending on other things has dropped, so health care becomes a bigger portion of the budget.

But that's part of the point. As health care costs and spending rise, the provincial governments are forced to provide fewer and fewer other services, in order to divert more resources to health care. Provincial governments are slowly evolving into single-service entities.

If health care is staying the same relative to GDP, but rising relative to other expenditures, it means that overall govt expenditure is shrinking relative to GDP. Ie we're spending less on govt relative to our income. So we can very well afford the health care we have. Saying that health care exceeds 50% of the budget, when the budget has gone down relative to income is a red herring. And there are lots of savings to be had that would get us more bang for the buck. Breaking the doctor's stranglehold for instance. They do lots of things now that could be done by RN's or nurse practitioners. And we should probably copy European countries and put the doctors on salaries.

[Scape]

Lots could be done on a wide scale preventive measures as well as long term, home care options. As it stands health care mandates are centered on the idea of primary care but preventive care and long term care are not. Also, the more effective the system becomes the more people depend upon it and then start assigning other priorities to it which are not a part of the mandate it was initially assigned to. So we get homeless in emergency beds.

Then there comes down to the fact that healthcare is developing care strategies for the most expensive demographic, retirees. There has never been such a demand upon it like this before and we have an onus to those that have paid into it to give the best care possible while at the same time ensuring the system doesn't collapse.

As for breaking monopolies of Doctors, here in BC we have begun that process as nurses and pharmacists can now renew treatments and in some instances perceive alternatives:

http://www.betterpharmacare.org/issues- ... eement.cfm

Quote:

As of January 1, 2009, pharmacists in British Columbia have an expanded role that allows them to: 1) renew prescriptions up to six months without requiring a doctor's prescription; 2) change the prescribed dose, formulation or regimen of a prescription; and 3) make a therapeutic drug substitution within the same class1.

So that the role of critical care is still firmly in the hands of the doctor but the more redundant and routine treatments that may need simple adaptation and good judgment can now be handled locally. Thus faster treatment, less congestion and wait times.

[PostFactum]

Cool, what I can't say about my country

[CKASlacker]

Any politician who honestly wishes to discuss health-care reform in Canada would be committing career suicide. Like the belief that we're the best in hockey, Canadians have an a patriotic attachment to the idea of "free" health-care for everyone, and will brook no argument otherwise.

It's really a sacred cow for most Canadians, along with the idea that *any* private/public tier reform would send us immediately down the path of our "evil, uncaring" neighbours where for-profit ideals trump compassion.

It's highly unrealistic and probably a childish attitude overall, but Canadian health-care is too wrapped up in our identity to seriously consider reform at this point.