# Health Care in Canada



## Dr.G. (Aug 4, 2001)

Two patients limp into two different Canadian medical clinics with the same complaint. Both have trouble walking and appear to require a hip replacement. The first patient is examined within the hour, is x-rayed the same day and has a time booked for surgery the following week. The second sees his family doctor after waiting a week for an appointment, then waits eighteen weeks to see a specialist, then gets an x-ray, which isn't reviewed for another month and finally has his surgery scheduled for a year from then. Why the different treatment for the two patients?

The first is a Labrador Retriever.
The second is a Senior Citizen.

I am told that I was lucky that I got an appointment to see a specialist to see my knee in November. I need surgery, which might be able to be scheduled in June of 2007.

I am NOT an advocate of a two-tier health care plan for Canada, but I have to wonder why I am able to get quicker care for my dachshunds than for myself.


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## Beej (Sep 10, 2005)

Despite all the high and mighty proclamations, two-tier will exist as long as other countries exist. Your example, albeit anecdotal, is interesting. Universal health care is a wonderful thing but, in public discourse, when any mention of 'two tier' is met with 'credit card medicine' you can expect more of the same. Welcome to the ideology of sacred cows over people. See numerous past ehmac threads.


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## RevMatt (Sep 10, 2005)

Wonderful discussion of the late and brilliant Jane Jacobs on Ideas last night. She described Public-Private partnerships and two tier health care as "Monstrous Hybrids", I think. Something just should not be provided for a profit. Or, to say the same thing another way, making a profit off of some things is simply evil.


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## Beej (Sep 10, 2005)

RevMatt said:


> making a profit off of some things is simply evil.


Then you really don't want to know about supplying medical equipment, building investments and (gasp!) doctor's wages. In an anecdotal example, a pet gets better health care therefore...what? No problems here, move along please.


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## MacDoc (Nov 3, 2001)

Perhaps the flip side should be considered. Euthanasia for dogs is quite acceptable. 

The ENTIRE game rules need to be considered..not just in isolation for a specific incidence.

If it say cost you $50k to "fix the dog".....would you?


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## Macfury (Feb 3, 2006)

My personal example. I needed a critical MRI and was told it would take 6 months in Toronto. I phoned "Buffalo MRI" in Buffalo, NY and they promised to provide the service for $600. I could come in THE NEXT DAY, and my results would be on my doctor's desk within 48 hours. They also had a non-confining MRI machine unavailable here.

That they might make a profit on this service bothered me not a whit.


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## Dr.G. (Aug 4, 2001)

"Perhaps the flip side should be considered. Euthanasia for dogs is quite acceptable." MacDoc, I wish I had the same choice as the one I have made for various family pets we have owned. I do NOT want a prolonged and pain-filled suffering existence (i.e., a non-life for myself, in my opinion). If I have to, I would take my own life, but I would rather it be ended with a degree of dignity, as I have tried to live my life.

Re my knee, while I was shocked, I am being told that I am actually lucky. It is better in other provinces, but I am here in NL. Luckily, if I could walk the 2km, I am that close to the hospital, so I am not required to live away from home just to see this doctor. We shall see.


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## Beej (Sep 10, 2005)

Dr.G. said:


> "Perhaps the flip side should be considered. Euthanasia for dogs is quite acceptable." MacDoc, I wish I had the same choice as the one I have made for various family pets we have owned. I do NOT want a prolonged and pain-filled suffering existence (i.e., a non-life for myself, in my opinion). If I have to, I would take my own life, but I would rather it be ended with a degree of dignity, as I have tried to live my life.


This is a major-minor issue. Major to those who care, minor to those who don't. As is often the case, MD and I are in a similar but not the same sphere.

It really bothers me, but I've come to accept that society just doesn't seem ready to support individual choice in this matter (with appropriately mind-numbing bureaucratic paperwork as a backstop). 

To me, it seems obvious that anyone over 18 should have this choice, even regardless of their health circumstances, if they're willing to jump through intentionally delaying hoops to ensure a 'sound mind'. This is one of those artifacts of our past that must go in its time. Understandably, attraction to the past changes slowly (see soft drugs), but reality will set in. My body, my life: we can do this with a mess or without one.


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## Beej (Sep 10, 2005)

http://www.cbc.ca/story/canada/national/2006/05/24/quebecad05242006.html

The ad sounds horrid but this statement is interesting:
....
Paying people more money for doing the same thing does not give one iota more in services to the public," he said.
....

They just don't get it.


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## CubaMark (Feb 16, 2001)

Lay the blame where it belongs: the under-funding of the health care system combined with ridiculous costs associated with, among others, the concessions given by the Mulroney government to the pharmaceutical giants that keep generics at bay.

Publicly-run health care can be as efficient as for-profit clinics. The question is: why is this not the case? 

Conceptually, I favour public control of vital services such as health care and power generation (I'm still seething over the privatization of the publicly-owned and profitable Nova Scotia Power Corp.), among others. Some things are too important to be left entirely in the hands of the ever-fickle market.


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## Dr.G. (Aug 4, 2001)

"It really bothers me, but I've come to accept that society just doesn't seem ready to support individual choice in this matter." Beej, on this issue, we are in agreement. Paix, mon ami.


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## MannyP Design (Jun 8, 2000)

RevMatt said:


> Wonderful discussion of the late and brilliant Jane Jacobs on Ideas last night. She described Public-Private partnerships and two tier health care as "Monstrous Hybrids", I think. Something just should not be provided for a profit. Or, to say the same thing another way, making a profit off of some things is simply evil.


Laura and I couldn't find a family doctor in Hull so we had to find a GP in Ottawa. After about 5 years of searching we did find one, however she doesn't look at children under 2 years of age AND we have to pay for every visit.

They do not accept health cards from outside provinces. Period. Cash-only--to the tune of $35 per visit (check-ups are around $65). The reimbursement from Quebec usually amounts to anywhere between 50% to 95% and it's NEVER the same amount reimbursed, regardless if it's the same type of visit OR patient. Between the two of us, I usually get a smaller reimbursement for the same type of visit. Go figure.

This is something that is not isolated to one particular doctor, clinic or hospital in Ottawa. There are few who will take the Quebec health card at face value without issue. We wanted to have our baby in Ottawa mainly because I speak very little French and feel more comfortable around English people but it would have cost us over $2,000 to deliver in Ottawa (that was the best estimate they could give us; it may have been more).

Universal health system? I don't think so.


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## Dr.G. (Aug 4, 2001)

MannyP, my mother was born in Montreal back in 1914. When she was 12, my grandmother brought her to New York City. She had a US Passport in that my grandmother became a US citizen. When I brought her here to live with me back in 1991, I needed to get her some health care when her MS became quite bad. I showed the hospital her Montreal birth certificate, but was told that without a Newfoundland Medical Care Plan card, I would have to pay $1200 day if she was hospitalized. She absolutely refused to go to the hospital, although I told her that I would take out a second mortgage on my house to pay for this. My own doctor came to see her and she repeated this demand to him, so that he could be a witness. He told me that if she was hospitalized, it could be weeks/months/years in the hospital, but that I could not force my mother into the hospital in that she was of sound mind, if not of sound body.

Two weeks later, my mother died peacefully in her sleep.


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## RevMatt (Sep 10, 2005)

MannyP, a good point. I don't really have much tolerance for Provinces running Health Care, but sadly, we are stuck with it without a referendum. I'm surprised you were able to find a doctor on this side of the line. We were unable to for quite some time. For future reference, Doctors in Ontario are required by law to accept new children of current patients as new patients. So if there are any more wee ones on the way, at least your doctor has to take them .

And $35 per visit is what OHIP pays doctors.


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## MacDoc (Nov 3, 2001)

Good genes there Dr. G :clap: .....your steel beneath velvet has provenance.

Beej start a "choice" thread.

I was only being slightly tongue in cheek on the "flip side' flippancy.
It's a fine line to walk to between under and over valuing human life and being willing to pay or go to desperate measures.

The controversy in preemie babies is quite incredible.


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## Beej (Sep 10, 2005)

No need to MD, the choice is there whether people want to admit or not.


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## MacDoc (Nov 3, 2001)

I wonder how many "fatal accidents" are suicides??


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## used to be jwoodget (Aug 22, 2002)

MacFury has the solution. If you don't like our system or don't want to wait and can afford to pay then pay your bucks to an American clinic. No one is stopping you. Best of both worlds..... Personally, I think we would lose an enormous part of the Canadian ideal if we give up on the principle of access to healthcare irrespective of ability to pay. It's a basic human right. There again, I'm all for improving the system, reducing the wait times and increasing efficiency. Indeed, I wouldn't necessarily mind a side-by-side private system in Canada - as long as it was not at the expense of public healthcare but was in addition to it. Unfortunately, I don't think that is possible and once the cat is out of the bag with respect to loosening the Canadian Healthcare Act, there would be no going back, regardless of the consequences.


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## Macfury (Feb 3, 2006)

The advantage of a side-by-side private health care system? Those who use it still pay taxes to support the public one, whil easing the burden on it. I'm for it.

The rasison d'etre of public health seems to have switched from:

a) everyone deserves decent health care, regardless of ability to pay

to

b) nobody should be allowed to have better health care than I get for free.

That's wrong. I won't sacrifice my health to pay lip service to a concept


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## RevMatt (Sep 10, 2005)

MacDoc said:


> I wonder how many "fatal accidents" are suicides??


Given that suicide cancels life insurance, I am sure that fake accidents are quite common.


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## Vandave (Feb 26, 2005)

CubaMark said:


> Publicly-run health care can be as efficient as for-profit clinics. The question is: why is this not the case?


Because bureaucrats are not businessmen. They have no interest in being efficient or profitable. They would rather cover their ass.


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## ArtistSeries (Nov 8, 2004)

Vandave said:


> Because bureaucrats are not businessmen. They have no interest in being efficient or profitable. They would rather cover their ass.


And businessmen have no interest in people, they only want profit, service and quality be damned....


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## Macfury (Feb 3, 2006)

ArtistSeries said:


> And businessmen have no interest in people, they only want profit, service and quality be damned....


I'd be happy to deal with people who want to make a profit for what they do well--they're largely the only group I trust.


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## Vandave (Feb 26, 2005)

ArtistSeries said:


> And businessmen have no interest in people, they only want profit, service and quality be damned....


You can define levels of service and quality that must be met. It works in all sorts of industries (e.g. airlines).


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## ArtistSeries (Nov 8, 2004)

Vandave said:


> You can define levels of service and quality that must be met. It works in all sorts of industries (e.g. airlines).


Better find another example.... 
Big airlines are a model of being cheap with customers, offering poor service and often subject to large government corporate welfare... is this what you are hoping for?


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## Vandave (Feb 26, 2005)

ArtistSeries said:


> Better find another example....
> Big airlines are a model of being cheap with customers, offering poor service and often subject to large government corporate welfare... is this what you are hoping for?


OK, here are better examples.... components of our health care system, the dental system and the vetrinary system (as Dr. G pointed out, dogs can get better health care than us).


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## Macfury (Feb 3, 2006)

Au contraire, AS--the airline industry has found a price/service point that attracts the most customers. Greater levels of service are available, but not at the price people in general wish to pay.

On the other hand, in the government model, I'm forced to pay to support whatever government bureaucracies exist bu thave no option to opt out. In many cases, there are no alternative services because the government has outlawed them to keep competitors at bay.


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## ArtistSeries (Nov 8, 2004)

Vandave said:


> OK, here are better examples.... components of our health care system, the dental system and the vetrinary system (as Dr. G pointed out, dogs can get better health care than us).


Would have to define the goals.
With dental care, a good segment of the population just does not go.
With vet care, there is some expensive care available but it's out of the reach of most....


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## Macfury (Feb 3, 2006)

AS: You're just demanding top service for bottom dollar. Impossible in either public or private models.


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## Vandave (Feb 26, 2005)

ArtistSeries said:


> Would have to define the goals.
> With dental care, a good segment of the population just does not go.
> With vet care, there is some expensive care available but it's out of the reach of most....


Hence universal coverage and guaranteed service levels.


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## ThirtyOne (Jan 18, 2003)

« MannyP Design » said:


> Laura and I couldn't find a family doctor in Hull so we had to find a GP in Ottawa. After about 5 years of searching we did find one, however she doesn't look at children under 2 years of age AND we have to pay for every visit.


I am really amazed by this, as my wife and I are going through the same thing as we prepare our return to the NCR, only in reverse. We can't find a doctor in Ottawa (even though I grew up there) so we've had to focus our search on the other side of the river. Even my parents' GP won't agree to see us, despite having looked after me and my sister when we were young.

All my life I have been a fierce proponent of Canada's public universal health care system. However, after 5 years out in Asia where, fortunately, we've never once had to worry about access to a doctor or to medical services because of private facilities, now that we're coming back home to Canada we can't even find a pediatrician for our two kids. I'm really starting to think that it is about time we had a serious debate on health care in Canada, rather than just a pointless ideological screaming match (You're a facist for wanting two-tier service!!! You're a commie for wanting universal care!!!)


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## Dr.G. (Aug 4, 2001)

"Good genes there Dr. G .....your steel beneath velvet has provenance." Merci, MacDoc. Paix, mon ami.


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## MannyP Design (Jun 8, 2000)

ThirtyOne said:


> I am really amazed by this, as my wife and I are going through the same thing as we prepare our return to the NCR, only in reverse. We can't find a doctor in Ottawa (even though I grew up there) so we've had to focus our search on the other side of the river. Even my parents' GP won't agree to see us, despite having looked after me and my sister when we were young.
> 
> All my life I have been a fierce proponent of Canada's public universal health care system. However, after 5 years out in Asia where, fortunately, we've never once had to worry about access to a doctor or to medical services because of private facilities, now that we're coming back home to Canada we can't even find a pediatrician for our two kids. I'm really starting to think that it is about time we had a serious debate on health care in Canada, rather than just a pointless ideological screaming match (You're a facist for wanting two-tier service!!! You're a commie for wanting universal care!!!)


Don't get me started on pediatricians... we still don't have one for Xander and we've been searching since we found out we were pregnant. It's worse than trying to find daycare.

Oddly enough--the US has so many pediatricians, they practically double the child population. Go figure.


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## Pelao (Oct 2, 2003)

What strikes me is the inconsistency in the health care delivery. My experience of the system has been nothing but excellent. From quite serious hospital care, through finding a family doctor and pediatrician to a 24 wait for an urgent MRI. In a country of our wealth (in terms of money and skills) it is unacceptable that everyone should not share this experience. Manny's experiences in finding medical care, and the financial impact, is simply disgusting.

I lived in the UK for many years, then in Holland and South Africa. One thing held in common is that noone seems particularly happy with their health care. I siuspect that this is because the target is constantly moving - demographic trends, science, technology, education etc.

I firmly believe that a two-tier system will be bad for Canada. Private provision of care outside the public finances is not clear cut medicine. To my mind though, it does not matter much how the care is delivered as long as everyone has equal access, when they need it, to the same level of care. In other words, if privately operated concerns can deliver, paid by public funds and offering a single level of service, then why not? 

But, like many things Canadian, health care would could do with a dose of leadership. Some 'nailing the colours to the mast' stuff. There was much talk last year of setting targets, but then Provinces can opt out, or face no loss of financial supporrt if they don't reach the targets. Clearly the complexity of our federal / provincial politics is at play.

We seem to be good at this - grand statements with no bite or muscle. Too many politicians and not enough leaders.


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## Macfury (Feb 3, 2006)

Pelao said:


> To my mind though, it does not matter much how the care is delivered as long as everyone has equal access, when they need it, to the same level of care.


Are you saying that a person who is dying shouldn't be able to spend his/her life savings on a procedure that--while not offered to the general public for free--should be denied them for fear of offending those who can't or won't pay for it?

Are you saying that I shouldn't cash in my RRSPs to purchase a critical operation or procedure--on the belief that I may die if I don't receive it soon enough--because others might be offended that my choice is not available to them for free?

Please elaborate.


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## MACSPECTRUM (Oct 31, 2002)

Macfury said:


> Are you saying that a person who is dying shouldn't be able to spend his/her life savings on a procedure that--while not offered to the general public for free--should be denied them for fear of offending those who can't or won't pay for it?
> 
> Are you saying that I shouldn't cash in my RRSPs to purchase a critical operation or procedure--on the belief that I may die if I don't receive it soon enough--because others might be offended that my choice is not available to them for free?
> 
> Please elaborate.



Sure they can.
It's only a short flight to many U.S. health centres.

Canadains should be offered the right to euthensia and hospice services to allow people to die with dignity.


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## Pelao (Oct 2, 2003)

> Are you saying that a person who is dying shouldn't be able to spend his/her life savings on a procedure that--while not offered to the general public for free--should be denied them for fear of offending those who can't or won't pay for it?
> 
> Are you saying that I shouldn't cash in my RRSPs to purchase a critical operation or procedure--on the belief that I may die if I don't receive it soon enough--because others might be offended that my choice is not available to them for free?


I am not concerned about people being offended. If that's what you think publicly provided services are for, then we share different views on their origins.

Can you offer examples of procedures that would save a life that are not offered "to the general public"? There may be some now that are not offered in good time, and that should be fixed, but what specific life saving procedures are concerning you?

With regard to the RRSP axample - I am sayoing that in a properly managed care system you would not _need_ to even consider such a thing.


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## Macfury (Feb 3, 2006)

Pelao: It's no secret that public health care cost control is based on rationing of health services. Providing all services available for free, on time is simply not in their mandate and never will be. Part of the understanding is that the waiting period will cause the deaths of some people who are unlikely to benefit from an expensive procedure.

Though in Ontario, it's more a case of delaying necessary surgery, an example of a non-covered procedure is Enhanced External Counter Pulsation a procedure used to treat angina.

As technology develops, expensive surgical options and medical procedures will proliferate. Government will not be able to pay for them all.


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## Pelao (Oct 2, 2003)

> Pelao: It's no secret that public health care cost control is based on rationing of health services. Providing all services available for free, on time is simply not in their mandate and never will be. Part of the understanding is that the waiting period will cause the deaths of some people who are unlikely to benefit from an expensive procedure.
> 
> Though in Ontario, it's more a case of delaying necessary surgery, an example of a non-covered procedure is Enhanced External Counter Pulsation a procedure used to treat angina.
> 
> As technology develops, expensive surgical options and medical procedures will proliferate. Government will not be able to pay for them all.


I have no disagreements with what you say as comments on the situation as it is _now_. But I believe the understanding (as you call it) can be altered.

It's the future that concerns me.

I would never assume that _all_ services should be available on demand. But I do not believe it is beyond Canadian ingenuity or financial resources to ration more effectively. I don't accept that government will be unable to pay for it. there are many financial models that have not been explored.

the simple introduction of separate access to health care for those with means will, I believe, cause more problems than it will solve. 

I believe the challenge is that we do not have clear leadership, objectives and management regarding health care.


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## Macfury (Feb 3, 2006)

Pelao: I think the disagreement is on whether the cost of available medical procedures can ever exceed the budget of the government paying for them. I believe you eventually hit a point where people who would never consider having a certain procedure would want it because its available and its free. The cost of providing all "available" procedures to all who want them could exceed all tax revenue.

An imaginary example. Suppose a treatment could be created that, let loose in the bloodstream would eliminate the likelihood of developing Alzheimer's disease? Suppose the procedure cost $50,000 to administer. Who wouldn't want it? Many people would take out a second mortgage to receive such a treatment. The government could never afford to give it to everyone. 

How should such treatment be dealt with in a socialist model?


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## Pelao (Oct 2, 2003)

> Pelao: I think the disagreement is on whether the cost of available medical procedures can ever exceed the budget of the government paying for them. I believe you eventually hit a point where people who would never consider having a certain procedure would want it because its available and its free. The cost of providing all "available" procedures to all who want them could exceed all tax revenue.
> 
> An imaginary example. Suppose a treatment could be created that, let loose in the bloodstream would eliminate the likelihood of developing Alzheimer's disease? Suppose the procedure cost $50,000 to administer. Who wouldn't want it? Many people would take out a second mortgage to receive such a treatment. The government could never afford to give it to everyone.
> 
> How should such treatment be dealt with in a socialist model?


I don't see that as the disagreement at all. Clearly some compromises have to be made. As for what would work in a Socalist model, I have not given it a lot of thought. I don't believe that is what we have in Canada, and I would not advocate it's introduction.

In any model, on any subject, it is possible to expose extremes where the model cannot cope. I do not feel there is an idealist solution. I do however, believe that a broadly workable solution can be found.


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## Macfury (Feb 3, 2006)

In a two-tiered model, the only compromises that need to be made are in the public health component--the same compromises it makes now. Remember that the public component continues to be funded by people who choose private care.


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## Pelao (Oct 2, 2003)

> In a two-tiered model, the only compromises that need to be made are in the public health component--the same compromises it makes now. Remember that the public component continues to be funded by people who choose private care.


We would part company here. That is not the only comprpmise. One obvious example - the private sector would bleed the public of it's most skilled staff.

The issue I have is with tiers. Why do you feel tiers are good? Why not simply engage the advantages of private supply within a public system?


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## Vandave (Feb 26, 2005)

Pelao said:


> Why not simply engage the advantages of private supply within a public system?


Because it's not simple. 

Bureaucrats are not businessmen. There is no profit motive or motive for innovation. Bureaucrats get rewarded for not making decisions and for covering their ass.


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## Pelao (Oct 2, 2003)

> Because it's not simple.
> 
> Bureaucrats are not businessmen. There is no profit motive or motive for innovation. Bureaucrats get rewarded for not making decisions and for covering their ass.


Of course it's not simple to implement, but I suggest that is no reason to avoid attempting something. 

Perhaps I did not exaplin myself clearly enough. What I am suggesting is nothing new. It's simply that private suppliers do work on behalf of government agencies. Happens all the time. Nothing new.

As for your comments regarding bureaucrats, well, it seems a bit of a bald statement. I don't see that's what they are paid for. Do some of them operate like that? Perhaps. So do plenty in the private sector. The behavoir does not necessarily come from the structure and is perhaps more related to the management and culture of the organization.

I am on the receiving end of government departments and services as a citizen and in business. My experience has been that Canada offers excellent public services. In addition, the service is constantly eveolving to improve service. Is it the best it can be in all departments, at all levels? Certainly not. Shockingly enough, neither are private sector providers....


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## ArtistSeries (Nov 8, 2004)

Pelao said:


> We would part company here. That is not the only comprpmise. One obvious example - the private sector would bleed the public of it's most skilled staff.


It goes beyond that. Public facilities are used for private operations, resources are drawn from the public sector weakening it while adding benefits to the private sector only...


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## Macfury (Feb 3, 2006)

If the private sector would "steal" the staff of public hospitals by paying them more--isn't that an indictment of ur public health system. Are we deliberately underpaying them so they earn less than market wages.

Nice to getthoize them then.


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## guytoronto (Jun 25, 2005)

Let's get a few facts straight:

Two-tier health care exists. It's here. It's not going anywhere. Here's how it works.

I have a job. I get benefits. Benefits include dental, eye, medication, etc. Somebody without my benefits must pay for the things I get for cheap. That is two-tier.

As pointed out earlier in the thread, Buffalo MRI will do the MRI for $$$, and give the results to your family doctor. If you have the $$$, you go to Buffalo, save 6 months of waiting, and be done with it. If you don't have the money, then you are screwed. That is two-tier.

So why the argument about expanding two-tier in Canada? Because too many people are holding onto the notion that everybody should be treated equally. In reality, we are already at a point where that is not the case. Your argument doesn't work.

Allowing a private clinic in Toronto is going to make public health care worse? How so, when there is a private clinic two-hours away in Buffalo? It's a short drive. Is the Buffalo clinic sapping money from Canada's health care system? Show me how, because I can see no way how some private company on the other side of the border sucks the life out of our health system.

And if it doesn't, how does moving that health clinic to this side of the border magically make matters worse? Are they stealing doctors and nurses? I think not. There already is a shortage of both, and that's without a whole bunch of private clinics. So the shortage isn't caused by private clinics. Something else is the problem.

Our health care system does need help. Private clinics could actually HELP our system. Unfortunately, too many people cry whenever two-tier is mentioned.


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## Macfury (Feb 3, 2006)

guytoronto said:


> Unfortunately, too many people cry whenever two-tier is mentioned.


This is because they have fallen in love with the concept. Tommy Douglas. Rah! Rah! 

But you're right, it's already over. It never really was.


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## ArtistSeries (Nov 8, 2004)

Macfury said:


> If the private sector would "steal" the staff of public hospitals by paying them more--isn't that an indictment of ur public health system. Are we deliberately underpaying them so they earn less than market wages.


You know, the cost of medical education is a lot less expensive in Canada than in the U.S. (I'm assuming that's where you are drawing parallels) - we are subsidizing their education. And because of our neighbours to the South, you seem to have a distorted view of the salary of doctors worldwide.


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## ErnstNL (Apr 12, 2003)

Using the example of having a private MRI clinic:
Why is there a wait list for MRI's? The machines are costly, they need a bunch of people to operate them and a radiologist has to interpret and sign off the results.
Is there a shortage of radiologists? Yes. 
Is there a shortage of qualified operators? Yes.
Because these are limited resources and by stealing the MRI techs and support staff from the public sector, a private service hurts everyone.


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## ArtistSeries (Nov 8, 2004)

guytoronto said:


> So why the argument about expanding two-tier in Canada? Because too many people are holding onto the notion that everybody should be treated equally.


This reminds me of the story of Mark Inglis and his team who left a man to die alone on Everest so that he could continue his ascent. 
As long as you get what you want, screw everyone....


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## Macfury (Feb 3, 2006)

Ernst: This is nonsense. We only appear concerned about worker shortages when our cherished concepts of socialized medicine are threatened. If private sector companies will be hiring qualified MRI technicians, then more people will decide to become qualified MRI technicians. Our biggest labour shortages in medicine (doctors, nurses, etc.) exist because we cap their wages to help promulgate a failing system.


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## Macfury (Feb 3, 2006)

Another analogy. When a new high-tech company comes into town, we talk about high-tech employment opportunities. Concern over competition with existing high-tech companies is minimal.

If the competition is a government bureaucracy, the foremost thought seems to be: "They'll steal our skilled workers," not "This will expand the health care sector in Canada."


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## ArtistSeries (Nov 8, 2004)

Macfury said:


> Another analogy. When a new high-tech company comes into town, we talk about high-tech employment opportunities. Concern over competition with existing high-tech companies is minimal."


But the competition for qualified employees is fierce...


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## Macfury (Feb 3, 2006)

Competition may be fierce, but this is always temporary in growing industries. We never see a city begging a company not to move into its boundaries, for fear that they might compete for skilled workers.


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## Beej (Sep 10, 2005)

When a Canadian goes to the U.S. for health care they increase U.S. demand for their doctors, our doctors and overseas doctors that we are also competing for. There is no reason to tell that Canadian to cross the border just so we maintain a sense of self-satisfaction. We need to think about this a little more broadly and realize that as long as other countries exist, there will be two tiers. Now, with a demonstrated ability to house top medical expertise, why are we importing medical care? 

Universal health care is an example of a very good idea that was implemented with a damaging rigid ideology instead of a sense of how best to follow-through on the really good idea.


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## Macfury (Feb 3, 2006)

I think the "universal" in universal health care was intended to apply to a level of care available universally to all Canadians regardless of ability to pay, not a universal slate of health care options available for free to all Canadians.


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## ErnstNL (Apr 12, 2003)

_Macfury wrote:
If private sector companies will be hiring qualified MRI technicians, then more people will decide to become qualified MRI technicians. Our biggest labour shortages in medicine (doctors, nurses, etc.) exist because we cap their wages to help promulgate a failing system._

Nonsense?

So, why are all the available slots for training in Canada for Radiology, Nursing, Radiography, Lab Medicine etc... are always filled to max. The majority of the grads stay here in Canada. Your simple explanation of a complicated problem is faulty.


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## Macfury (Feb 3, 2006)

Let me restate--in those areas where we cap wages we would see a siphoning off to private industry who might pay more. In many health care fields, the number of grads is capped by agreement with professional associations to limit entry into the field, creating a manufactured shortage.

However, if we can agree that we have no shortage in the areas you just mentioned, then private services could easily find new, skilled workers to hire.


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## ErnstNL (Apr 12, 2003)

Healthcare needs an overhaul, we all agree. 
One solution (2 tier) will not fix it.

The pressures within the system are mounting:

Healthcare is not all doctors and nurses. 
Support services are essential and the real backbone to what kind of care we receive in the hospital, home or Community Health Services.
Ongoing training when new technology becomes available.
Succession planning for an aging workforce is lacking. 30% of all the healthcare workforce is eligible to retire in the next 2-4 years. Our N&L healthcare boards and Dept of Health and Community Services recognized the problem 10 years ago. It's still not a priority.
Mounting costs of basics like electricity.

Private Healthcare will face all the same problems. So, why is it the solution?


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## Beej (Sep 10, 2005)

Almost every industry is facing the labour crunch. Interestingly they're all developing strategies to get more workers from the same pool. Hmmm, that won't work.

We have limited sources, but there are a number bright spots out there: a better immigration system and untapped Canadians (old and young). Don't just figure out how to dominate the pool, make the pool bigger.

Without a doubt private health care will face the same problems. Highly skilled professionals will go where they want. Most will stay in Canada but, at the margins (not sure of the %) they will move. We can ignore that or work with that.


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## Vandave (Feb 26, 2005)

Beej said:


> Without a doubt private health care will face the same problems. Highly skilled professionals will go where they want. Most will stay in Canada but, at the margins (not sure of the %) they will move. We can ignore that or work with that.


It's already that way for a lot of industries and professions. Myself, I can easily get another job at any number of companies within the day. 

I think companies need to be more accomodating to workers that want more flexibility. For example many people with young kids might only want to work for a couple days a week, or retired people might want to contribute in limited ways as well. I don't see a lot of that happening in the professions right now, but it is only around the corner.


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## Macfury (Feb 3, 2006)

I agree with Beej and VanDave. Trying to "hoard" skilled workers for the public service isn't a viable option. But economies do expand as has the health care sector itself. Opening up areas currently forbidden by provincial law to competition may result in short-term shortages of skilled labour, but long-term expansion of the market.

Official two-tiered medicine, alone, is not a solution to health care delivery problems, but it does take some pressure off the public health care system while users continue to fund it. If it becomes clear that private suppliers are using hospital facilities at a subsidized rate--make 'em pay for it, or make them move out to their own premises.


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## used to be jwoodget (Aug 22, 2002)

Two tier medicine would most definitely not relieve the public system of its pressures - quite the opposite, it would exacerbate them. Why? Because the private clinics would not offer universal service and would directly compete for professionals. The most risky and expensive procedures would be left to the public sector. If you have a profit motive, then what business in the world would not try to maximize it? There is no panacea for the increasing health costs and the endemic pressures on our system. However, private healthcare will only pick off the procedures and coverages that are profitable - obviously.


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## guytoronto (Jun 25, 2005)

ArtistSeries said:


> This reminds me of the story of Mark Inglis and his team who left a man to die alone on Everest so that he could continue his ascent.
> As long as you get what you want, screw everyone....


Weak. Very weak argument.



MacDoc said:


> Perhaps the flip side should be considered. Euthanasia for dogs is quite acceptable.


What? Huh? How do we go from access to medical procedures and two-tier health care to this?



CubaMark said:


> Lay the blame where it belongs: the under-funding of the health care system combined with ridiculous costs associated with, among others, the concessions given by the Mulroney government to the pharmaceutical giants that keep generics at bay.


How do pharmaceutical giants (who, by the way, develop the medicines that many of us use) cause the under-funding and mismanagment of our healthcare system? They don't. Another weak argument.


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## Macfury (Feb 3, 2006)

used to be jwoodget said:


> ...private clinics would not offer universal service and would directly compete for professionals.


Of course it wouldn't be universal service by its very definition!! The clinics would compete for professionals and more would graduate from schools to fill the vacancies. 



used to be jwoodget said:


> The most risky and expensive procedures would be left to the public sector... private healthcare will only pick off the procedures and coverages that are profitable - obviously.


And the net effect would be that people would pay to have these particular services performed at a private clinic...when they could get them for free? That makes no sense to me. In all likelihood people would pay a premium to have procedures performed faster.

But if I bought your argument, you're implying that losing these procedures would "cost" public health care? Why? They don't offer any service on a for-profit basis anyway.


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## ErnstNL (Apr 12, 2003)

So, if 2 tier healthcare is available for a procedure like... MRI investigation for a suspicious chest mass. 
The patient is paying for the MRI procedure only, the taxpayer is still on the hook for all the follow-up and surgery if needed, all the drugs, all the hospital care...Should the person that started the private diagnostic services process then pay for the rest of the care needed at diagnosis?

The taxpayer is still on the hook for the greatest portion of the whole process.
Is there a savings to the taxpayer? because the public MRI machine is still going full tilt in the hospital? No.
Invest and overhaul the existing system.
Better overall for everyone.


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## Dr.G. (Aug 4, 2001)

"Invest and overhaul the existing system. Better overall for everyone." I agree with ErnstNL's contention, especially here in NL.


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## CubaMark (Feb 16, 2001)

guytoronto said:


> How do pharmaceutical giants (who, by the way, develop the medicines that many of us use) cause the under-funding and mismanagment of our healthcare system? They don't. Another weak argument.


guytoronto, thanks for the obvious statement - <i>I had no idea that pharmaceutical giants make medicines!</i> (insert sarcastic emoticon here)

The extended patent protection brought in by the Mulroney government is a significant factor in the draining of financial resources - our health care system has to spend millions more for brand-name drugs:


> multinationals will make windfall profits as a result of extended patent protection. Consider the case of the brand-name drug Vasotec. It is estimated that without the cheaper generic – Enalapril – the added cost to Canadians will average $50 million annually ’til the patent expires in 2008. Vasotec is made by Merck-Frosst, who stand to make nearly $1.4 billion in extra profits as a result of the recent legislation.


<div align=right>Source: <a href="http://www.newint.org/issue246/patents.htm">New Internationalist</a></div>

The <a href="http://www.cdma-acfpp.org/en/issues/noc_regulations.shtml">Canadian Generic Pharmaceuticals Association</a> - certainly no left-wing commie movement - is quite clear in its criticism:


> The Patented Medicines (Notice of Compliance) Regulations
> 
> What are the Patented Medicines (Notice of Compliance) Regulations?
> In 1993, the Mulroney government passed Bill C-91, which extended pharmaceutical patents in Canada from 17 to 20 years.
> ...


For anyone interested in educating themselves about the intentional redirection of Health Care from public to for-profit (rather than just opining), read the extensive material available from the <a href="http://www.canadians.org/[email protected]@205ce123e2aa4c0a2fcac64c67863ca5&step=2&catid=39&iscat=1">Council of Canadians</a>.

M


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## Macfury (Feb 3, 2006)

ErnstNL said:


> So, if 2 tier healthcare is available for a procedure like... MRI investigation for a suspicious chest mass. The patient is paying for the MRI procedure only..Should the person that started the private diagnostic services process then pay for the rest of the care needed at diagnosis? The taxpayer is still on the hook for the greatest portion of the whole process.
> Is there a savings to the taxpayer? because the public MRI machine is still going full tilt in the hospital?


Here, you've exposed one of the problems with public health care. The MRI is still going full tilt because public health has fallen so far behind in providing MRI scans. The huge dealy in getting MRIs might DELAY necessary treatment for a chest mass. When are treatments usually less expensive? With EARLY detetction. 

The taxpayer is on the hook either way for the free treatment. By delaying treatment, it's possible the public system might save money by having the paient die while waiting for surgery--in the public model, this is a cost savings.

My suspicion is that a certain number of people would opt to pay for immediate treatment (as Canadian politicians do in U.S. clinics).

The burden on public health care is certainly no greter, and everyone moves up a notch in the MRI schedule. The patient continues to subsidize the slow MRI scans through taxes.


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## Macfury (Feb 3, 2006)

CubaMark said:


> guytoronto, thanks for the obvious statement - <i>I had no idea that pharmaceutical giants make medicines!</i>The extended patent protection brought in by the Mulroney government is a significant factor in the draining of financial resources - our health care system has to spend millions more for brand-name drugs.


I find this argument absurd. Let's reduce copyright protection, because the cost of books is draining our resources on the fight against illiteracy. Let's also limit patent protection on computer technology, because the drain on capital to provide new computers is sapping the financial resurces of Canadians. 

This is like saying that unions are sapping the financial ability of the Canadian government to provide services, because non-union staff could fill most positions much less expensively. (That's true, but I doubt you would want to admit this extension of your aguument.)

I'm the beneficiary of an expensive niche drug that would not EXIST unless there was some profit motive attached. Do you have any idea how much it costs to develop a succesful drug--let alone the ones that never make it to market? Sure-tell the drug companies what their profits should be, then watch the number of miracle drugs decline to next to nothing.


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## MacDoc (Nov 3, 2001)

> Quote:
> Originally Posted by MacDoc
> Perhaps the flip side should be considered. Euthanasia for dogs is quite acceptable.
> What? Huh? How do we go from access to medical procedures and two-tier health care to this?


Perhaps you should read the entire thread instead of jumping in with both feet looking foolish. Did you even READ the original post?

•••

In my mind the private sector role in health care is to compete to provide the financing and the equipment for the public sector.


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## CubaMark (Feb 16, 2001)

Macfury said:


> I find this argument absurd......I'm the beneficiary of an expensive niche drug that would not EXIST unless there was some profit motive attached. Do you have any idea how much it costs to develop a succesful drug--let alone the ones that never make it to market? Sure-tell the drug companies what their profits should be, then watch the number of miracle drugs decline to next to nothing.


The simple fact that there is legislation providing multinational corporations with any protection from generic competitors is proof that the argument is far from absurd - the question is, how long is the protection period? At what point does protection begin to equal unreasonable profit? We as a society get to set the rules (I can't believe I just wrote that) regarding who gets to play in our space, provide what services, and under what conditions. The multinationals have been making unreasonably large profits from extended patent protection for at least 13 years (and, arguably, much longer).

But this is <b>one</b> aspect of the Health Care system crisis. Has anyone bothered to read the <a href="http://www.hc-sc.gc.ca/english/care/romanow/index1.html">Romanow Report</a>? (<a href="http://popups.ctv.ca/content/publish/popups/healthcare/key_points/romanow_points.html">Key Points</a>) Four pages of back-and-forth on Health Care, and this is the first mention of that comprehensive inquiry? How short are our collective memories...

M.


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## Macfury (Feb 3, 2006)

CubaMark--how long do YOU believe their patents should be protected?


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## CubaMark (Feb 16, 2001)

In 2001, prescription drug costs ate up 12.1% of the Health Care budget (up from 5.8% in 1980). As I said, it's <b>one piece</b> of the puzzle. I have no idea how long protection should be - neither does Romanow. The report calls for a body to review drug costs to balance out the intellectual property / public good equation. He also stated:


> A particular concern with current pharmaceutical industry practice is the process of “evergreening,” where manufacturers of brand name drugs make variations to existing drugs in order to extend their patent coverage. This delays the ability of generic manufacturers to develop cheaper products for the marketplace and it is a questionable outcome of Canada’s patent law.


<div align="right">Source: <a href="http://www.hc-sc.gc.ca/english/pdf/romanow/pdfs/HCC_Chapter_9.pdf">Chapter 9, Romanow Report</a> (PDF)</div>


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## MacDoc (Nov 3, 2001)

There is also a serious issue with drug companies benefitting from university research which is publicly funded and in some cases suborning that research to cover testing issues.
The entire area admits of no easy answers and I indeed think sovereign interests will trump drug co interests - as in Brazil where the gov stared down one of the majors and got it's way.
The major agreed to supply the drug for less than the cost of the generics threatened by the gov.
We'll see more of that.

Areas that I'm dismayed with ( and Cuba does well with ) is low cost remedies being offered.
These areas are crying for research but it's under the radar for drug companies as there is little profit in it.
There are hundreds of low cost pharma products based on plant and marine compounds that could provide immense relief.

The days of true "public health" efforts seem numbered. We need another Rockefeller Foundation effort to bring low cost effective drugs on the scene in volume.


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## Macfury (Feb 3, 2006)

CubaMark said:


> In 2001, prescription drug costs ate up 12.1% of the Health Care budget (up from 5.8% in 1980).


But what does this mean? There are five times as many drugs available today as there were in 1980. How does the use of drugs limit the needs for surgery and other treatments, etc. Not a straightforward relationship at all.

I agree with MacDoc on this, though, that publicly funded institutions should charge drug companies for their research, if the drug companies find the research worthwhile.


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## MacDoc (Nov 3, 2001)

> that publicly funded institutions should charge drug companies for their research, if the drug companies find the research worthwhile.


I'd put a bit of a variation on that....when the research is tied to commercial results then pure research tends to get set aside in search of commercially valuable products.

I'd say an oversight body that acts on behalf of all publicly derived intellectual property and funnels the proceeds back into the institutions in the form of grants dissociated from the specific "windfall" would serve better.
That way pure research is not slanted but commercially viable products help fund the system as a whole rather than one great bonanza for a specific lab while the others go begging.

I don't think individual institutions should be out negotiating royalties directly.

In this way as well - drugs and therapies that may NOT be commerically profitable but of great public interest - ie a low cost malaria cycle disruptor can get grant funding perhaps byway of success in the market of an anti aging creme.


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## Macfury (Feb 3, 2006)

MacDoc.....yes, that makes sense.


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## Beej (Sep 10, 2005)

MacDoc said:


> I'd put a bit of a variation on that....when the research is tied to commercial results then pure research tends to get set aside in search of commercially valuable products.
> 
> I'd say an oversight body that acts on behalf of all publicly derived intellectual property and funnels the proceeds back into the institutions in the form of grants dissociated from the specific "windfall" would serve better.
> That way pure research is not slanted but commercially viable products help fund the system as a whole rather than one great bonanza for a specific lab while the others go begging.
> ...


Interesting idea. 

We also need to realise that we do get a 'free ride' on pharma research and that we can take advantage of this, but should we? Our market will barely influence U.S. pharma research (we could kill our tiny industry to boot, if we really dislike them). However, those types of arguments apply to most U.S. copyrights and patents. How many inventions/creations have longer or shorter protections? Making the 'but this is more important argument' won't fly: it would be abusing foreign patents, plain and simple. MD's idea, though, sounds worth exploring.


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## MacDoc (Nov 3, 2001)

Canada is woefully slipping back to hewers of water and carriers of wood  Our RD and expenditures on research are far below G8 norms .

We DID have some strong "champion" industries at one time. Pretty thin now.

We don't hear much about the MARS centre which was supposed to put us on cutting edge for integrated biological/medical research.

I'd love to see a dedicated portion of the surpluses or resoource windfall put to a strong R&D funding.


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## used to be jwoodget (Aug 22, 2002)

Macfury said:


> Of course it wouldn't be universal service by its very definition!! The clinics would compete for professionals and more would graduate from schools to fill the vacancies.
> 
> And the net effect would be that people would pay to have these particular services performed at a private clinic...when they could get them for free? That makes no sense to me. In all likelihood people would pay a premium to have procedures performed faster.
> 
> But if I bought your argument, you're implying that losing these procedures would "cost" public health care? Why? They don't offer any service on a for-profit basis anyway.


Because the public system cannot turn people away. It cannot pick and choose who or what to treat. Because the public system requires no ability to pay. Because there is a finite pool of people who are trained and training takes 10 years. Because your argument is in play today: since people can go to the US and pay, but this opportunity does not appear to be benefiting our public health system. If anything, it is deleterious since it is drawing professionals from Canada.


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## PenguinBoy (Aug 16, 2005)

MacDoc said:


> I'd love to see a dedicated portion of the surpluses or resoource windfall put to a strong R&D funding.


You'll be glad to hear that at least some of the "resource windfall" is going to R&D: http://www.cbc.ca/calgary/story/ca-cancer20060222.html


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## PenguinBoy (Aug 16, 2005)

Macfury said:


> Let's reduce copyright protection, because the cost of books is draining our resources on the fight against illiteracy. Let's also limit patent protection on computer technology, because the drain on capital to provide new computers is sapping the financial resurces of Canadians.


IMHO, all of these things should be examined. Good laws should balance the public interest with the interests of the creators of "intellectual property", unfortunately in many cases the "creators" have strong well funded organizations to advocate for them, whilst the public often does not.

I'm not sure where the "sweet spot" is for pharmacutical companies, but this should be examined. I don't believe that patents are an "all or nothing" proposition, it should be possible to achieve a balance that encourages research and innovation yet keeps costs reasonable for the public.


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## Beej (Sep 10, 2005)

used to be jwoodget said:


> Because there is a finite pool of people who are trained
> ....
> and training takes 10 years.
> ....
> Because your argument is in play today: since people can go to the US and pay, but this opportunity does not appear to be benefiting our public health system. If anything, it is deleterious since it is drawing professionals from Canada.


In the world. Important distinction from finite available to Canada.
....
Health care planning needs to consider a lot more than now, and even 10 years from now.
....
Again, as long as other countries exist, this problem will exist (short of removing rights from medical professionals). Note: 'drawing professionals from Canada'. If only there were some way to offset that draw. Hmmm....

Do we deal with it by giving up and hoping we can keep enough professionals despite the draw, or by giving the professionals more reason and options under which to be here?

This problem exists for all highly skilled workers. For some reason, only for medicine do people think the solution involves institutionalizing a large portion of the profession and actively stomping out private involvement. Maybe we need more psychiatrists to research this.


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## Macfury (Feb 3, 2006)

The public sector can't choose who to treat, regardless of whether private facilities exist. When people don't use these services and go to a private provider, the resources required to treat these people remains inside the public health care system.

People can go to the U.S. for treatment, yes--most major Canadian politicians have. Every time a Canadian goes to the U.S. for service, it benefits the Canadian public health care system. Better still if the money remained here through home grown private clinics.

Skilled labour is not a finite resource. Demand creates supply. I don't buy the argument that private clinics create a permanent labour shortage. But if Canadians are moving to the U.S. to work there in the medical field (show me the stats), it's because working conditions are better, and taxes are lower.


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## used to be jwoodget (Aug 22, 2002)

The last election saw a total of $100 million being added to efforts for all areas of federally funded research in Canada, representing an "increase of 2.5%. It's ironic that this comes at a time when we have never been in a better position to recruit scientists from the US due to the significant diversion of funds from research into "other" activities in the USA. We are eating our seed corn (both here and in the USA). In the meantime, Japan has announced a new 5 year plan to invest $25 billion in research. Moreover, China is planning to annually invest 2.5% of its GDP into research and development over the next fifteen years. That's (currently) US$35 billion (Chinas GDP is growing at 8% a year). We spend US$3.5 billion..... Sure, China is bigger than Canada, but there is no silver medal for patents.


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## Macfury (Feb 3, 2006)

Canada is always touted as a nanotech leader, but our R&D efforts here are pretty minimal. We will be eaten alive by the U.S., Germany and Japan when nanotech becomes the next "industrial revolution."


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## used to be jwoodget (Aug 22, 2002)

> Skilled labour is not a finite resource


 So, skilled labour is an infinite resource? By that argument, the only limiting factor for healthcare is the amount of money available to it. Hence, why not increase it through taxes and maintain universal access to all? The rich pay a bit more, because they pay more in taxes (because they also earn more). Meanwhile, there are no medical bills on the doorstep and no insurance bills for industry to pay helping them to remain competitive and create jobs. Everyone benefits.


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## used to be jwoodget (Aug 22, 2002)

We have a couple of good research centres in nanotechnology (there's a new NRC lab in Edmonton, for example). However, we will all be eaten alive by China..... Nanotech is currently more hype than reality but its a bet we cannot afford to duck.


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## Beej (Sep 10, 2005)

Oddly, I think Alberta is the nanotech leader in Canada for government attention.

Research funding is generally, but not always, a good thing. Be careful when bureaucrats decide what to fund. Also be careful about handing money bags to academics. So, if we wanted to quadruple R&D in Canada, to whom do we hand the money? What are the criteria? Difficult question with, I'm sure, a variety of opinions.


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## MacDoc (Nov 3, 2001)

> Because the public system cannot turn people away. It cannot pick and choose who or what to treat.


and because euthanasia for "too costly" patient is not available for humans. Hence my earlier crack.

••

Research and champion funding??? - Canada should be looking to Singapore for a model - makes us look absolutely ridiculous.
They don't talk about it....they DO it.

Canada should be partnering with China, India and Singapore in some areas such as medical training and getting mutually acceptable standards in place.


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## Beej (Sep 10, 2005)

used to be jwoodget said:


> So, skilled labour is an infinite resource? By that argument, the only limiting factor for healthcare is the amount of money available to it. Hence, why not increase it through taxes and maintain universal access to all? The rich pay a bit more, because they pay more in taxes (because they also earn more). Meanwhile, there are no medical bills on the doorstep and no insurance bills for industry to pay helping them to remain competitive and create jobs. Everyone benefits.


Unlimited tax resources would be great. Maintaining universal access to all is great, but ignoring reality isn't. There will always be a 'better' option for those with money, why make them spend it elsewhere? Ideology. 

You could always keep shovelling money into the universal option, and that sounds good, until you work through it. How much money will it take, how much education and R&D funding will it crowd out (people do have a finite desire to be taxed) and what are you accomplishing? 

For a private clinic to open up and be used at 50% capacity to serve the impatient wealthy is one thing (it will charge very high rates). For the public system to build in 50% overcapacity to provide the same service to everyone is another.


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## used to be jwoodget (Aug 22, 2002)

Beej said:


> Research funding is generally, but not always, a good thing. Be careful when bureaucrats decide what to fund. Also be careful about handing money bags to academics. So, if we wanted to quadruple R&D in Canada, to whom do we hand the money? What are the criteria? Difficult question with, I'm sure, a variety of opinions.


I'm biased (a researcher dependent on research grant funding to do research) but we (under)fund only about 20% of the best research in this country. It's highly competitive. The success rates are around 10-25%. We have the capacity thanks to our excellent educational system. We even have a lot of the infrastructure. However, we don't have the political will. We seem to take our excellent performance in research at the international level for granted (pun not intended). Seriously, while no one expects the government to suddenly turn around and say here's an extra few billion a year as of today, a 2.5% increase in Federal funding for all research is going backwards. What does this say about our aspiration? To become a developing world player?


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## Macfury (Feb 3, 2006)

Skilled labour is neither infinite nor fixed--it fluctuates. But Beej pretty much said what I would have.

Canada does great nanotech research, when it does it, but is lousy at marketing it. Much of it remains academic.

The NINT in Alberta (they're just moving into the new building) may be a good model, because it has nanotech scientists, business people, U of A academics, and scientists in other disciplines jammed together in the same building. There's reason to believe, based on experience elsewhere, that the cros-pollination will help solve some research problems and help to make ideas more marketable as well.


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## Macfury (Feb 3, 2006)

Beej: nanotech is spread out in various nodes across Canada, in concert with the NRC and a research universities. Another node is in Sherbrooke. The NINT looks like the most advanced and up to date facilty though.


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## Beej (Sep 10, 2005)

It's Friday and I'm too lazy to open a tab and google.

What is NINT and, aside from up to date, where gets the most nano-attention. 

Off-topic but not, I think this is useful information. Sorry if anyone disagrees.


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## MacDoc (Nov 3, 2001)

That's the MARS concept as well and it's not just IN the building but the other institutions like Sick Kids nearby providing a larger "centre of excellence".
Synergy in the 20th century jargon.


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## Macfury (Feb 3, 2006)

Beej: It's the NRC's National Institute for Nanotechnology:

http://nint-innt.nrc-cnrc.gc.ca/home/index_e.html

They built it on the U of A Campus in a technologically advanced "Quiet building" with outrageous vibration dampening technology. Even the elevators had to be specially designed to prevent electromagnetic force fluctuations as the cars passed through the Earth's magnetic field.

I spoke to the builders and they said that, ideally, if you had wanted to engineer a building like this, you should build it out in a cornfield--but then they wouldn't be able to attract interesting people to work there. Having it on campus and inviting researchers from other disciplines, corporations and venture capitalists--all sorts of people--to be tenants here will ideally see the research leading to cross-pollination and advances in other sciences--and seeing some of the research pay off commercially. The new building officially opens on June 1, I believe.


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## Beej (Sep 10, 2005)

Thanks. Pity the Edmontonians when the nano armies escape.


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## SINC (Feb 16, 2001)

Beej said:


> Thanks. Pity the Edmontonians when the nano armies escape.


Shhhhhh, you'll wake us up . . .


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## Dr.G. (Aug 4, 2001)

Sleep is a blessing in The City of Champions.


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