Friday, June 10, 2005

The New Health Care System

Yesterday's ruling on health care definitely paves the way
for the most significant changes in access to health care
services since a universal medical plan was brought in.

There is no doubt in my mind that there is already a two,
or three tier system of care in this country as it stands.
There are private clinics operating around the country,
which those with enough money can access, while those
who aren't rich, or privileged enough wait for the same
services and treatment. Ultimately, what this decision
reiterates is that the Canadian health care system, as
it currently functions, is failing many Canadians. The
system is unable to provide citizens with access to timely,
important, sometimes life saving, medical treatment
and intervention. This court ruling simply validates what
many Canadians already know. Insight and validation are
first steps towards real opportunities for dialogue on the
future of health care in this country.

This decision, although it only involves Quebec at this
point, clearly illustrates where the rest of our provinces
will be going. There is nothing entirely surprising about
this, as it reflect the governance paradigm of New Public
Management, the wave of the future for federal and
provincial governance. More and more private-public
enterprises will be occurring in different fields. I'm
going to try to avoid the usual negative rhetoric and
adopt more of a wait & see attitude about how this
will play out.

More and more I'm becoming a pragmatist. If we think
we've face a health care crisis now, just wait until the Baby
Boomers are fully upon us all en masse, as they will be
soon. This generation is used to the best of everything,
when they want and need it. With the inevitable health
decline, or problems, that come with age for most people,
I can't help but think that if they can afford it, why
shouldn't they pay for it, leaving the rest of the system
for those of us who can't afford it?

It's one of those slippery slope, thorny issues, I'm not even
entirely sure how I feel about it all. What I do know is that for
me and most of my age mates, most of us can't afford to own
property, let alone afford private health care. And we are
already taxed to the max, to pay for Old Age pensions, employ-
ment insurance, neither program which any of us have a hope
of benefitting from. Now we're being told these younger gener-
ation aren't getting an early start on putting money into RRSP's,
otherwise, we won't have enough for our retirement.
The Gen X & Y's, as we're called, are assuming debt at earlier
ages than any other generations. Most of us, especially those
living in the urban jungles struggle to pay rent, can't afford
mortgages. I wonder if I'm the only one who feels like all the
decisions being made are embedded in the present, with very
little thought for the future and who will be paying for things
down the road.

I guess we should start to see an abundance of American
companies moving in now too. They must be licking their chops,
with all the trade agreements making it so easy. HMO's must
have been watching this case particularly close. The BC Liberals
and other neo-con governments around the country, must be filled
with glee, more BC money to end up in American coffers, the
plan is working.

I don't think it has to be a big loss for the unions, they just better
be very strategic in planning how to organize this sector once the
ball is really rolling.

Ultimately, I guess we'll have to wait and see what becomes of it all.
Praise, Censure for MD's Crusade:
Man Who Challenged Canada's Health Act says

StruggleWas Similar to Ghandi's

Globe & Mail, (Friday, June 10, 2005), Page A9.

MONTREAL -- Jacques Chaoulli, the eccentric Montreal physician
who has rattled the foundations of medicare, was hailed as a hero
or decried as a villain yesterday -- while the man himself was
drawing parallels to modern-day revolutionaries.

Dr. Chaoulli, whose one-man crusade led to the top court ruling,
restated his belief that countries whose health systems are privately
funded in part, such as those in France and Switzerland, serve
patients better than Canada's publicly financed system. As a
physician -- he still practises family medicine in the middle-class
district of Saint-LĂ©onard -- he says he witnessed too many patients
suffer and even die while waiting for medical procedures.

He predicted the court ruling would reverberate across Canada.
"How could you imagine that Quebeckers may live and the English
Canadian has to die?" That would give new meaning to Quebec
being recognized as a "distinct society," he said.
By Ross Marowits (June 9, 2005). Canoe News.
Provinces respond to ruling

Health Minister Philippe Couillard said any two-tier health
system would simply end draining up an already depleted
health-care workforce.

"If we have this parallel system, what we may see is doctors
going away from the public system toward this new parallel
system and making wait times worse for people who can't
afford these insurance contracts.

But Paul Brunet, the head of a patients' rights group, criticized
the Supreme Court judgment, saying it will undermine public
health care in Quebec.

"It definitely won't be the same and I'm not sure that ordinary
people are going to win out with this," said Brunet, who works
with the Conseil pour la protection des malades.

"Once you start attacking free and public health-care access
for everyone, we're just one step away from having all these
values and pillars crumble."

Brunet said setting up a parallel system would hurt the poorest
in society, who don't have the means to pay for health care and
who are also the people who get sick the most.

He added no study has shown that private health care is
cheaper in the long term than public health care.

Union leaders denounced the ruling as a threat to public
health care and an intrusion into Quebec politics.

A cure for what ails Conservatives
By , (Fri, June 10, 2005). The Ottawa Sun.

According to the court, governments (in this case the government
of Quebec), don't have the right to impose a death penalty or
undue pain and suffering on Quebecers by forbidding them
access to private medical services which the public system
can't provide in a timely way.

"The evidence in this case," the court wrote, "shows that delays
in the public health care system are widespread, and that, in some
serious cases, patients die as a result of waiting lists for public
health care."

The court made another crucially important finding: "It cannot be
concluded from the evidence concerning the Quebec plan or the
plans of the other provinces of Canada, or from the evolution of
the systems of various OECD countries, that an absolute
prohibition on private insurance is necessary to protect the integrity
of the public plan."

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