Last Updated: Friday - 09/24/2010
Week of April 24, 2000
More on why I oppose Bill 11
By BISHOP FRED HENRY
Our health care system is widely perceived to be in crisis. Indeed, there is more than enough evidence to support such a conclusion and the point made by the government that "the status quo is not an option" seems persuasive.
However, despite the amendments, I don't believe Bill 11 is the answer.
As a result of my last venture into the health care debate, I received a number of letters disagreeing with my views. The arguments fell into different categories.
Category I - Money: "If public administration were to mean that providers of health care would be given necessary funding to provide necessary care while working under fairly general guidelines and under fiscal control, the system might work."
My response is that "might" is a bit weak but it's a moot point as such a state of affairs doesn't yet exist. Although more money needs to be committed to health care delivery, the solution isn't infusing more money for more capacity and more services.
Category 2 - Inefficiencies: "Public administration of hospitals has been proven to be inefficient, expensive, unworkable and beyond repair."
This thesis is unproven but accepted as a given by those who fail to recognize that quite significant improvements in hospital efficiency took place during the period of the cuts - for example, the excessive use of in-patient beds has been elminated. As a matter of fact, the pendulum may have swung too far.
Category 3 - Waiting lists: "Because of hospital closures, waiting lists have been unacceptably prolonged, the only alternative is providing surgical care for simpler conditions in a private clinic."
I have a problem with the conclusion. We don't have to go down that road and we shouldn't just yet. We probably need to tone down the rhetoric and acquire more hard data to define the problem - who is waiting, how long, why, and what is the most effective response.
Most of the data tends to be anecdotal. This is a great tool for extracting money from the political system but not all that useful in developing a strategic plan.
The privatization option is particularly odious, because by its very nature it rewards the creation and preservation of waiting lists. This raises the interesting transparency question - precisely who profits by the privatizing of health care?
Nevertheless, we do have a real problem, especially those waiting for care. What we need are new options, new approaches on both a large and small scale. The approach to solving the waiting list problem for MRIs is perhaps instructive. The waiting period in the public system for an MRI has been measured in months; in the private system, days.
However, now that the pressure is on, the Calgary Regional Health Authority recently reversed itself and said it will add an extra shift and/or work weekends to improve this situation; that is, hire new personnel, which cuts down on outside providers and improves access. An interesting development!
What they haven't admitted publicly yet is that it's also cheaper in the long run.
We should explore other cost saving measures, such as a national pharmacare program to lessen the ever-escalating costs of drugs, expanded home care, reconsideration of roles of nurse practitioners in delivering primary care, etc.
Category 4 - Left wing nuts: "If you don't agree with Bill II, then you must be some kind of "left-wing nut."
Such summary dismissive tactics miss the mark. However, there is good precedent for them in New Testament times -- the townsfolk of Nazareth upon hearing Jesus address them in the synagogue reacted similarly: "When they heard this, all in the synagogue were filled with rage. They got up, drove him out of town, and led him up to the brow of the hill on which their town was built, so that they might hurl him off the cliff."
They probably thought he was a "left-wing nut too." His proclamation provoked a reaction because he challenged their behaviour and very being because they hadn't heard and internalized the message as evidenced by their complacency and compromises.
However, I suppose that there is some legitimacy to the leftist allegation when you consider that since medicare is financed by taxes, and available to all free of charge, a greater share of the burden is carried by those with higher incomes and the principal beneficiaries are those in the poorest health.
It is certainly clear that any shift from the public towards more private funding would transfer income from lower to higher income people, as well as from the ill to the healthy. Taxes are correlated with income; private payments are not.
Category 5 - Humour: An author, who chose to remain anonymous, put an interesting spin on thing's in this recently received e-mail:
When some doctors were asked to comment on the Alberta government's Bill 11:
The allergists voted to scratch it.
The dermatologists preferred no rash moves.
The gastroenterologists had a gut feeling about it.
The microsurgeons were thinking along the same vein.
The neurologists thought the administration "had a lot of nerve."
The obstetricians stated they were labouring under a misconception.
The ophthalmologists considered the idea short-sighted.
The orthopedists issued a joint resolution.
The parasitologists said, "Well, if you encyst."
The pathologists yelled, "Over my dead body!".
The pediatricians said, "Grow up!"
The proctologists said, "We are in arrears."
The psychiatrists thought it was madness.
The radiologists could see right through it.
The internists thought it was a hard pill to swallow.
The plastic surgeons said, "This puts a whole new face on the matter."
The podiatrists thought it was a big step forward.
The physiotherapists thought they were being manipulated.
The urologists felt the scheme wouldn't hold water.
The anesthesiologists thought the whole idea was a gas.
The cardiologists didn't have the heart to say no.
The audiologists were deaf to the idea.
The surgeons decided to wash their hand of the whole thing.
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