So what the heck went wrong in Canada? I can't speak for other provinces since each of them can make independent decisions on how to spend the money they receive from the federal government for health care, I can only offer my opinion on Ontario
politics and how bad decisions (in my view) have ruined what used to be a good system.
Way back when we used to pay health premiums in this province. Now this was really not an odious amount of money, something like 30 bucks a month for single and 50 for families. As always, people on welfare were exempt. It was felt that this wasn't generating enough income. Instead of raising the rate, in early 1990 the new government (NDP very left) abolished it altogether and replaced with an Employee Health Tax. It was supposed to generate lots more money and make health care better for all of us.
I remember at the time that my employer, a very large real estate firm immediately fired every agent and rehired them as "independent contractors". The employers had no intention of taking that financial hit and because as an "independent contractor" you paid it yourself except if you earned under a certain income level. So lots of people didn't pay a dime. Even so that brought the government an extra billion dollars in income in the beginning. I suspect but don't know for certain that with the recession of 90/91 there were a lot of people who didn't have to pay anymore and I know for certain that most realtors I worked with in those days were well under the income level.
Must have not been enough money after. The government closed hospitals, reduced beds in those that were left and worst of all cut spaces in med school. Somehow they thought we had too many doctors and that was what was draining the health care budget. It didn't stop there, they then took on doctors directly and decided on how much they would receive per patient visit effectively making them employees of the government. That amount stands at around $37.00 for a General Practitioner today. The other thing the government did was to limit the amount a doctor could bill yearly, in other words earn.
Because of the small amount of money they earned per visit they started rushing patients. No more than 10 minutes per visit and no more than one problem per visit. There is actually a sign in my doctors office that states it clearly. Before doctors became "employees" in our socialized country they could order refills of drugs on the phone, call you with test results and do referrals to specialists also on the phone and importantly listen to the patient. Now each of those things requires an office visit with usually a one or two week wait for an appointment.
As a result of being made "employees" of the government, two things happened, almost like a perfect storm. Doctors packed up and moved to America where what they could earn was unlimited, especially specialists and when a doctor here hit his income level he stopped taking patients. My own doctor only works half days on Fridays and never on an evening. Oh yes I almost forgot, there weren't enough doctors coming out of med school to replace the ones that left for greener pastures. By the time the government of the day realized it, it was too late. In Ontario there are just 84 doctors per 100,000 persons (last known figure). Might be 83 soon as I can see my own physician getting tired and burned out. There are 1.5 million people in Canada without a primary care
So where do all these people go for medical care? Well the ER of course, where else. I have seen people there with cuts on their fingers or toes, sniffles, a rash etc. stuff that should be treated in a walk in clinic or doctors office. I heard somewhere (can't confirm) that a visit to the ER costs just over 500 bucks whereas a doctors visit, well we know that's around 37 bucks. Interestingly as I was writing this post our Minister of Health David Caplan was just on the news talking about emergency room visits and he said that 5 million people used the ER last year with only half being true emergencies. That's got to deplete the kitty somewhat...
Any talk of privatization brings outrage from the general public. It is considered "two tier" medicine and in this country where most inhabitants are so used to being taken care of from "cradle to grave" the idea of paying for something is alien. It would seem to me that a private medical clinic that is funded by the government would be a real money saver? Right about now I'd glad pay to have my vision restored but cant unless I go to the U.S.
Here's the thing though, we already have two tier medicine, it's just not common knowledge. Most workers for example are covered under Workers Compensation. If these people get injured on the job and are staying off work due to an injury they get moved to the front of the line. The reason is that workers comp pays the hospital directly and pays more than the government fee. Took me a while to figure out actually, when you see a specialist you fill out a little form and one of the questions is "is this a workers comp injury". People with private insurance also have benefits the rest of us don't. They get private or semi private rooms in hospitals while the plebes get a ward, they have drug and dental coverage which is not generally covered unless your on welfare and god forbid you get some awful disaese like cancer
, the drug bills would wipe you out in a year.
The specialist that we are hoping will see Steve for his hand claims to specialize in workers comp cases! That's not two tier? Or the sports players who get injured here during various games, they pay cold hard cash to be treated because they aren't covered by our health plan. They go straight to the front of the line.
This is the system that President Obama would like to see in the U.S. Is this really the only solution? I keep hoping for a politician to come along and fix our mess but none of them have the guts. Canadians being what they are would vote anyone out of power who took away the "entitlements" no matter how crappy they really are.
If you are a senior in this province, unless you have a lot of money, life is even more tough. Conditions in old age homes are pathetically inadequate. People are left sitting in soiled diapers most of the day and the last Minister of Health
was lambasted for trivializing it. After the initial outrage, did anything change? According to a good friend who does a lot of volunteer work in a seniors residence nothing has changed. Again, I know from the experience with my mother that this happens in hospitals as well. Short staffed was always the excuse I was given with my mother. In SEVEN weeks my mother did not get one shower, not even one.
Our own Premier McGuinty runs away from any serious questions and spouts platitudes. I have a drawer full of form letters from him in response to queries. His Minister of Health, David Caplan didn't even both answering my email. During election campaigns they all talk big, there are so many promises it's hard to keep track. Once elected they hope we forget them. Our current premier made over 200 promises when he was first elected and managed to break over a hundred of them the first 6 months. But four years later, guess what...people have short memories and he was reelected. That's why I've lost all faith in politicians of any stripe, they say the things you want to hear but hardly ever follow through.
And the solution is? Kick them all out and elect some real leaders...