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Another view on the medicare issue. I agree
that we live in a multi-tiered society, but would continue to make the point
that there are some services that should be considered as lieing outside of a
tier system based on income, wealth and class connections. Among
these, health and education are the most basic.
Ed
Dear Ed:
As long as we keep on demanding and politicians
keep on promising every thing under the sun, we will all turn out to be BIG
loosers, eventually.
Whether it is roof over our head, education for our
children or healthcare etc. every service and/or facility has its price and its
priority customers.
Whereas our landscape is dotted with five start
hotels, we still have homeless hiding under drity blankets trying to survive
under freezing temperatures.
In other words, no one is entitled to and no one
gets to stay in Hilton just because he/she does not have any place to
live/sleep.
Not every one can afford to attend his/her
university of choice for higher education. In short, quality of goods and
services we buy or get depend upon one's ability/capacity to buy with money
or influence/connections.
In case of healthcare, all we should expect and
governments should promise is that every citizen of Canada is entitled to some "
basic" services. These basic services must be clearly identified and delivered
in an efficient fashion without unnecessary wait.
The rest requiring expensive technologies, highly
specialized professionals and luxurious surroundings should be available to
those who are willing to pay for them.
Failing that, we all will be standing in long lines
for ever or go to our graves dreaming for the perfect healthcare, if there was
ever such a thing.
Husain.
----- Original Message -----
Sent: Saturday, June 11, 2005 11:08
AM
Subject: Fw: End of a dream?
Last evening, my wife and I talked about what
we would do if our daughter or one of us, or someone else very close to
us, required urgent medical care that the present Canadian system could
not provide quickly enough. We agreed that we would do whatever we had
to to access that care, principle be damned.
Ed
----- Original Message -----
Sent: Friday, June 10, 2005 3:39 PM
Subject: RE: End of a dream?
Quick point - we already have a two tiered system. If you
don't like waiting in line, you can always head down to the States, or across
to India for the operation - and I believe the CND health system picks up a
portion of the tab. If you have an aggressive cancer that needs to be
treated right away (Bourassa comes to mind), people seem to have no
trouble thinking that crossing the border and paying Yankee dollars is a
problem.
At
some point I think there has to be a distinction made between 'health care',
and 'super man repairs'. The universal health care system is never
going to be able to provide customized DNA cloned body part repairs to
every citizen in the country - but it is legitimate to think that in
a rich society such as ours, that affluent citizens can buy that kind of
service if they are so inclined. Today's luxuries are tomorrows
commodities. Someone has to pay the money to prove the need, to bring in
the development money to bring down the price so that everyone can benefit
from the same service. In fact, I think it should be encouraged
that if you want to live 30 days longer for $100,000, that you should be able
to do so right here in Canada, without having to send that money out of the
country where we'll never see it again. It can only mean that the price
of extending life will come down, and we will all benefit in the end.
I
don't think that being rich in itself should be looked at as a disease.
If you can afford these things, and want to invest your money this way, you
should be able to do it - and not be dragged down into the mud by the
rest of the screaming masses because of it. My expectation is that the
rest of us, who have perhaps spent our lives more fruitfully other than
chasing dollars, or who have average expectations and average incomes, should
still be able to get world class health care that is well funded, that
isn't being bankrupt by 'superman science' type expenses, without having to
wait at the back of a very long line - a line that continues to grow
longer as the 'baby boom' generation starts checking in.
...
back to work.
Ever so many years ago when the world and I
were young in rural Saskatchewan some people were able to afford to go to
the doctor and get whatever treatment they needed. Others took
chickens and pigs with them because they had no money. Then along came
Tommy Douglas and universal single tier public health care.
Now the Supreme Court of Canada has rendered
a decision that opens the way for a two tier system, a private one for those
who can afford to pay, and a public one for those who can't. Many
people, including doctors and private insurers who are bound to benefit from
the private tier are jubilant. You can already hear them laughing on
their way to the bank. Many people will be able to get off the long
public waiting lines for various tests and surgeries and go directly to
their private clinic and have their needs met.
But for ever so many others, the large
majority, the lines will lengthen. The reason the lines are so long
now is because there isn't enough capacity in the system. They will
lengthen for those who cannot afford to be in the private tier because
many doctors and part of the diagnostic capacity will have moved over
to where the money is.
I suspect that it's diagnostic capacity and
specialized surgery that's the real problem. I can get an appointment
to see my doctor anytime, but if we then decide that I need MRI or a CTScan,
we may have to wait a couple of months. Waiting times for specialized
surgery is much longer. A friend of mine recently had her knees
replaced. Because she runs a stable, she uses her legs most of the day
everyday. Even so, she had to wait for more than a year.
For years now, everybody has been after the
federal government to fix up the public system. We've had a Royal
Commission and a major report from the Senate of Canada. Not much has
happened. The provinces have asked the federal government for more
money and the federal government has been unable to provide it. I
suspect costs are the big issue. Training good doctors is expensive,
training specialized doctors is even more expensive, but providing
the kind of diagnostic equipment that has now come into standard use is
hugely expensive. Paul Krugman, an American economist, recently
noted that a considerable proportion of the large cost increases encountered
in Medicare over the past couple of decades was due to the costs of the
technology now in standard use in the US. Canada uses the same
technology.
So, where will we be in a few years?
For some, the lines will greatly shorten. For most, they will become
very much longer, so long that their pain and suffering will make a good
case for assisted suicide, perhaps with government picking up some of the
costs.
Ed
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