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Healthcare in Canada

25/12/2013 Leave a comment

Over the break I’ve finally had time to (get close to) finishing Jeffrey Simpson’s newish book, Chronic Condition. Basically, Canada’s healthcare system is headed for crisis, but it’s a “political third rail”, a reference to the rail carrying power for electric trains – touch it, even with the best of intentions, and you die. The book is a brilliant look at how medicare happened, how it works in Canada and other countries, how it’s broken, and how to fix it.

What it boils down to is that between 1975 and 2006, we see:

  • 75.4% growth in GDP per capita
  • 51% growth in expenditures on hospitals
  • 98% growth in expenditures on physicians
  • 338% growth in expenditures on drugs outside of hospitals

(All figures adjusted for inflation)

This might be okay if our outcomes were enough to justify our spending, but by OECD standards they are decidedly mediocre. Moreover, this spending will likely continue to grow faster than the economy. Eventually, there will be a crunch on government budgets since taxes can’t rise indefinitely. In Simpson’s words:

The first and most important lesson about health care is that simple solutions to complicated problems are invariably wrong or deeply suspect… The decade ahead will feature slower economic growth in Canada and the rest of the Western world… Choices will be inescapable and hard.

Some of his proposed solutions:

  • constrain wage growth of healthcare professionals – doctors’ salaries alone represent 14% of healthcare spending (hospitals and drugs make up 29% and 16% respectively). “Unless physicians and nurses show more flexibility in how they work, and unless they accept that their remuneration cannot continue to outstrip governments’ revenue growth, it will be very hard to improve medicare’s challenges of quality, access, and cost.”
  • “dehospitalize” medicare by emphasizing home care, long-term care sites, nursing homes, and family and specialist clinics
  • institute regional health authorities where they don’t already exist and give them control over budgets
  • make physicians and nurses accountable to these regional authorities instead of the provincial government
  • encourage private delivery of publicly-paid services where costs are lower for equivalent services
  • encourage delivery of services by lower-cost providers, such as nurse-practitioners
  • allow hospitals to use operating rooms for privately-paid surgeries when not in use for other procedures
  • allot hospital budgets according to some base amount plus an additional sum for each patient treated instead of lump sums – make patients sources of revenue and not costs
  • lower drug costs through a national drug scheme
  • institute user fees to discourage overuse and offset or waive them for lower-income people
  • reduce social inequality – statistically, poor people have more health problems

Ironically, inequality is the most likely of these challenges to be addressed. Healthcare reform is politically unfeasible, hence Simpson’s ‘third rail’ moniker.

What makes healthcare the ‘third rail’ of Canadian politics? As Canadians, we have built our national identity around our healthcare system. Needed reforms threaten the interests of people working in healthcare – and these powerful groups know that by raising the scary spectre of private, Americanized healthcare, they can elicit a knee-jerk emotional reaction from the public that will prevent any changes.

Healthcare is part of a larger complex of social problems that really frustrates me. Regarding healthcare specifically, my generation is going to be on the hook for a host of cost increases and it’s going to be the quality of our healthcare that suffers as a result. Another example is the environment – the boomer and post-boomer generations are receiving all of the job and wage benefits but will not live to see the costs.

And we have to put up with all of this while the traditional media and the rest of the population tell us that we’re lazy, entitled, ungrateful, and socially dysfunctional. Right.

More “Old  Economy Steve” memes here.

LOL,

Tim

PS – Also, this:

Breaking News: Hostages of the Tea Party Take US Government, World Hostage

07/10/2013 Leave a comment

First headline on my FT feed this morning: “Republicans defiant over shutdown” – Boehner says HoR Republicans will not stop shutdown or lift debt ceiling unless Obama negotiates on Obamacare (hint: he won’t).

Second headline: “Global economy ‘back on track,’ finds Tiger Index”

So, in short, here’s what we’re looking at: Tea Party takes GOP hostage through America’s broken primary system. GOP takes US federal government hostage through being the single most intransigent group in Congress since, well, forever. Their main bargaining chip – a default on America’s sovereign debt – would have an international impact on financial and real markets and crush whatever recovery has been achieved.

We’re finally getting our economies back together and the Tea Party is holding the world hostage. Political assassination rarely seems this justified.

A Letter to the CBC

07/03/2013 Leave a comment

After a Facebook post drew my attention to the Journey of Nishiyuu, I wrote a letter to the CBC via their contact form. Basically, the Journey is a group of 6 Cree youth who have set out on a 1000-mile snowshoe trek to Parliament Hill. They have been joined along the way by members of the Mohawk and Algonquin Nations, amongst others, growing to over 70 walkers on the 4th. And somehow this has not been reported in the national meda. Go figure. Anyway, here’s the letter:

Good afternoon,

I’m sure you’ve received many emails about this, but here’s another.

The Journey of Nishiyuu started with 6 walkers and has since grown to over 70. This group of aboriginal youth is trekking over a thousand miles in the middle of winter to meet with the PMO. Following their traditional trade routes, the original 6 from the Cree nation are meeting with the Algonquin and Mohawk Nations, among others.

On 11 Feb 2013, you reported on a group of 50 aboriginal youth marching 250km to Winnipeg. (http://www.cbc.ca/news/canada/thunder-bay/story/2013/02/11/mb-jackhead-first-nation-walk-idlenomore.html)

The Journey of Nishiyuu involves more people, is six-and-a-half times as long, and is on snowshoes. They’re bound for Parliament Hill, not Winnipeg. Surely this is newsworthy?

Frankly, I’m shocked and disappointed that this hasn’t made national headlines yet.

You can find their website at http://nishiyuujourney.ca/

Regards,
Tim Logan

 

If you, like me, think this is dumb, write the CBC. Hopefully in the future this kind of thing will make news.

LOL,

Tim

Odd coincidences and the state of the Middle East

14/01/2013 Leave a comment

I was doing some research for a paper I wrote last semester on the Arab Spring and came across this quote in one of my sources. It’s funny how things work out sometimes, eh?

“History is filled with bizarre analogies. February 11, Mubarak’s day of departure, is also the day when the Shah of Iran’s regime fell in 1979… [but] Iran is a bad analogy for Egypt.

Better yet is South Africa. On February 11, Nelson Mandela was finally released after twenty-seven years in jail… For the Arab lands, the events of early 2011 were not the inauguration of a new history, but the continuation of an unfinished struggle that is a hundred years old.” – Vijay Prashad, Arab Spring, Libyan Winter

Read more…

Harper Ends Party Subsidies

20/05/2011 Leave a comment

Ottawa to cancel party subsidies with next budget – Need to know – Macleans.ca.

This means the Liberals are finished for sure. The entire left is being defunded – this has been Harper’s plan for years. Implications of this move include:

  • additional barriers to entry for new political parties (e.g., the Green Party)
  • a weaker left
  • large donations will have more impact (which go mostly to the Conservatives). In other words, money’s voice will get only louder.

Not good for Canada.

LOL,

Tim

#Jan25

09/02/2011 Leave a comment

Great music video, great lyrics (politics aside). If you’re impatient, skip to 3:40 – that is one of the most powerful things I’ve ever seen.

Don’t be fooled by the lack of mainstream coverage now, Egypt is still protesting. I don’t know what will happen, but I care about these protests both on an academic and personal level – some of my friends are Egyptian and have family living in Cairo.

Positive vibes to Egypt – may your fight be fruitful.

LOL,

Tim

PS – you can find Al Jazeera’s very good live blog here

Global Warming – Humanity’s IQ Test?

03/12/2010 Leave a comment

I was walking back from Indigo with a copy of Mark Sisson’s The Primal Blueprint in my backpack (really good so far, some very interesting stuff) and a thought I had struck me:

Global warming indicates that humanity is both the smartest and the stupidest creature on the face of the planet.

Why does it show our intelligence?

Well, quite simply, humanity’s greatest natural asset is our brain. We are physically weak, frail, and until basic tools came along, quite defenseless against any other animal bigger than us. The thing that has propelled us to the place we now occupy at the top of the food chain is our brain. When you really look at it, humans are amazingly intelligent. This intelligence lead us to tools and then to machines, and from there to electricity and computers and all the trappings of modern life.

The fact that I can change the temperature of my surroundings by walking over to a wall and turning a plastic dial is amazing. The fact that humanity is changing the temperature of the entire planet is also amazing – along with being very scary.

Global warming threatens more than just a few species of animals. It threatens billions of human lives and possibly the survival of the human race.

Which brings me to my second point. How does global warming prove we are the stupidest creature on the planet?

Look at the matter from a Darwinian point of view, for a second. Animals (us too!) are born to pass on their genes; in order to do so they must survive until they have reproduced; therefore we have powerful instincts of self-preservation. Nothing likes to die.

Despite the possible extinction of humanity, we continue to sit on our asses and do jack shit about the most serious crisis that Earth (forget humanity) has ever faced.

Our instinctive desire for self-preservation has been overcome by the desire to consume. And from an evolutionary point of view, that puts us right with the plants in terms of intelligence.

I think I speak for the entirety of my generation when I say that we do NOT want to be stuck cleaning up an environmental disaster left to us by the ones who came before us, like a bunch of bad houseguests.

So – politicians, industrial magnates, business leaders, and the rest of the crowd older than us, this one goes out to you:

WILL YOU PLEASE GET OFF YOUR ASSES AND DO SOMETHING ALREADY? You’re killing me here.

Because at the rate we’re going, we won’t be around for much longer. And that is the inconvenient truth.

LOL,

Tim