Conservatives would cut GST: Harper

[Mr. Photogeek]

wow that's crazy.. getting in to see a doctor around here is like pulling teeth.. even if you do get a scheduled appointment, you have to wait an hour or so cuz they're always running behind. go to google and type in : doctor shortages, canada and see what pops up. if you didn't already know of this, you'll be surprised.

I do realize there are some serious problems with access to doctors in some areas...in fact k-dub was like this for a long time, but thanks to some work by our government (at the municipal level) it seems to be a little better. I would imagine smaller towns have such a hard time because not as many doctors want to live in rural areas ([color:purple]Northern Exposure anyone ). Not sure why that is though...If my wife and I could make a living in a rural area we would be all over it!

[Birdy]

two tier health care system---hmmmmmm...

Birdy-- I realize this is a loaded question, but do you believe in equality?

loaded is an understatement!

of course i believe in equality, i just don't believe in government ordered equality.

to clarify, take same sex marriages. very generally, liberals believe that the government should pass law allowing same sex couples to marry, conservatives believe that the government should pass law disallowing same sex couples from marriage.. i believe the government shouldn't pass a law either way, as it should be an individual's choice, not the government's, to marry a person of the same sex or not.

[Birdy]

I do realize there are some serious problems with access to doctors in some areas...in fact k-dub was like this for a long time, but thanks to some work by our government (at the municipal level) it seems to be a little better. I would imagine smaller towns have such a hard time because not as many doctors want to live in rural areas ([color:purple]Northern Exposure anyone ). Not sure why that is though...If my wife and I could make a living in a rural area we would be all over it!

ahh there's lots of factors that come in to play.. lack of amenities, the brain drain, capitalism, liberalism, you name it, they all play a key role into the current state of affairs.

i'm all for living in rural areas, but even at the best of times, the lack of cultural contact and amenities can get even the best down.. especially during the long chilly winters. summers i love- beaches, water, camping, etc.. it's great.

[d_rawk]

Glad to hear the doctor shortage thing is getting better in K-Dub. I remember it being really bad when I was there.

As for the NDP announcement, it is getting spun in all sorts of ridiculous ways. It really isn't different than the party's original position. I think part of the problem comes from a confusion of terms when people talk about 'private'.

I mean, our system has always had an element of private. Doctors aren't government employees, but they receive public money for services rendered. When you go to get blood work or x-rays done, it is at a private lab, with fees payed by public money. Nobody was ever talking about eleminating every 'private' element, just halting the move towards a mixed private *pay* and public pay system, or corporate for-profit medicine that funnels money out of the public system into private coffers.

As for closing down existing private-pay clinics, there isn't a way for the federal government to do that, AFAIK, and its not like Layton was ever talking about becoming some sort of renegade clinic terrorist and blowing the places up on the sly.

The media got caught off guard because it doesn't fit into their charicature, stereotype idea of what the NDP position was. It is partly the NDP's fault, because they have had trouble getting their message across or to get candidates to express it clearly - usually talking in abstractions rather than specifics.

But the lack of basic journalistic research behind the articles that have been coming out today is disheartening.

[Dr_Evil_Mouse]

i believe the government shouldn't pass a law either way, as it should be an individual's choice, not the government's, to marry a person of the same sex or not.

Marriage is an essentially governmental prerogative, as has been as far back as the historical record shows (the historical record also shows that churches were a bit slow on the uptake - check out The Place of Churches in the Same-Sex Marriage Debate ). The rules change when you marry, around how money or custodial arrangements work, e.g. This says nothing about love, of course, which is where I've always put my own stock, but nobody should be fooled about the contractual nature of the arrangement, since it's one of the ways that governments (and the taxman) keep tabs on their people.

[ggrtrhhrtgg]

well, my question relates to your belief that a two-tier health care system should be implemented. I do see your point, it is quite valid, there are some serious problems with our health care system... However, if you believe in "equality" how can you support a two-tier health care system that would obviously favour those with money?

There is no way I would ever support a two-tier health care system, I LOVE the fact that I live in a country that provides every single Canadian citizen free access to a health care system, no matter how inefficient it may be...

[Dr_Evil_Mouse]

My dad just sent me an article from the Toronto Star (Nov. 27, D1) which I thought nicely connected the trends that led to fascism in Germany and Italy with what's going on today, in terms of the rampant drive to deregulation, the repeal of anti-trust laws, the endless call for tax cuts, and the self-sacrifice of democracy. Among my favourite bits -

Neo-liberals call relentlessly for tax cuts, which, in a previously progressive system, disproportionately favor the wealthy. Regarding the distribution of wealth, the neo-liberals have nothing to say. In the end, the rich get richer and the poor get poorer. As in Weimar Germany, the function of the state is being reduced to that of a steward for the interests of the moneyed elite. All that would be required now for a more rapid descent into fascism are a few reasons for the average person to forget he is being ripped off. Hatred of Arabs, fundamentalist Christianity or an illusory sense of perpetual war may well be taking the place of Hitler's hatred for communists and Jews.

Same article, different place -

Fascism Then. Fascism Now? When people think of fascism, they imagine Rows of goose-stepping storm troopers and puffy-chested dictators. What they don't see is the economic and political process that leads to the nightmare.

[Deeps]

but wouldn't you say that our current health care system is second-rate care? i definitely would. i called to book a check up with my family doctor last february... i'm scheduled for march of 2006. and thats not even remotely the tip of the iceberg. i'm lucky i even have a doctor.

obviously i don't think we should jump into a two-tier system without changing a few things outside of the traditional health care realm, but i think everyone can agree that something has to be done, soon.

Can someone explain to me what the big deal about having a "Family Doctor" is? I don't have one....I go to a walk in clinic. I am in and out of the place way faster then when I had a family doctor. They have my record on file. They are polite and efficient.

Unless you're getting up there in age, and I'm even skeptical whether or not this matters, the need for a family doctor seems a little questionable.

Everyone talks about it like they're going to keel over if their doctor isn't their FAMILY DOCTOR, please help me understand this dilemma.

[Freak By Night]

Can someone explain to me what the big deal about having a "Family Doctor" is?

You'll know the answer to this question when you're in your 40s and have a family.

It sounds like the clinic is right for your situation.

[d_rawk]

or suffer from a chronic illness whereby having a stable relationship with the same doctor is beneficial. And this problem transcends issues of age.

But yeah, Deeps, you raise a good point. Considering that MDs are increasingly in the business of firing off a quick prescription, or handing the patient off to a specialist, the clinics are probably adequate for the bulk of day to day needs.

[ollie]

Another advantage to having a family doctor is the personal level of service. I don't know how many doctors in clinics would go out of their way to make housecalls.

[Birdy]

walk in clinics in chatham-kent are absolutely terrible. you have to devote at least half a day to sitting in their waiting room to finally see a doctor... not really feasible if you're working and busy. last time i attempted was last winter when i had strep throat.. walked in to a packed waiting room at one minute to 8 in the morning, talked to the receptionist who told me to come back tomorrow, turned around and went to sit in emerge for four hours before finally seeing a doctor. i guess it really applies to those areas with crazy doctor shortages, when the majority of the population is trying to get into a walk in clinic. doctors are so worn out, you can see it in their eyes.. this is when they tend to fire off the prescription just to get you out of there and on to the next.. it's like a cattle herd.

i'll take my family doctor any day of the week.. at least she knows me, knows my brothers, my mom, my dad.. my grandparents, etc.. its just over all a way better experience and i feel like someone is actually truly taking care of me and i'm not just a number or a face in a waiting room.

[d_rawk]

I've heard that Chatham-kent is particularly bad (from meggo).

I wonder if a second-tier of private pay is going to solve that problem for you, though. If general practitioners aren't attracted to rural areas now, and are already in vastly limited supply, I'm not sure that they would be more attracted to rural areas when they are thrust into competition for the dollars of the urban rich. You'll be left with those who couldn't make it elsewhere. Market competition will hand you the failures.

I tend to think that the doctor shortage is artificially created. In 2002, the MP of Chatham-Kent seemed to agree:

Mr. Jerry Pickard (Chatham--Kent Essex, Lib.): Mr. Speaker, it is a real privilege for me to get involved in the debate today. One of the problems we all face in health care is trying to deliver in a timely and efficient manner a service that has increased dramatically in cost while attempting to deal with the multitude of problems Canadians see.

Through discussions I have had I believe most people in Canada wish to see a health care system: first, that they can count on; second, that delivers the service in a timely and efficient manner; third, that makes sure doctors and nurses are available where they are needed; and fourth, that offers people affordable access to the prescription drugs they need.

Canadians are finding major problems with health care. A large group of people do not have the health care services that should be afforded to them. In the area I live in thousands of people are without a family doctor because there are not enough doctors to cover all families. People go to clinics or hospitals for health services and they receive them. However there is a doctor shortage in rural Canada and in smaller cities. We do not seem to be dealing with the question as well as we need to.

There are many reasons for the doctor shortage. First, we do not have a proper number of facilities to train health care professionals. A great deal of change needs to occur in our training and approval process to make sure we have adequate health care professionals be it doctors, nurses or technicians.

Second, 10 to 15 years ago dramatically incorrect assumptions were made which led to the crunch on doctors and nurses today. Many older doctors in Canada had gone on and on with their practices and never retired. In estimating how many doctors we would need in the year 2002 it was not taken into account that many of these doctors would take retirement. As a result we are short in that field.

We did not take into account the number of specialists we would have in the system. Those who specialize in obstetrics or various illnesses have been taken out of the general practice system. As a result the numbers of doctors to carry on family practice has been limited dramatically.

A new phenomena today is that there are clinics in many areas. Many doctors operating in clinics may not be able to handle the long term illnesses of seniors or people with cancer or other debilitating illnesses which require long term care. As a result family doctors are being more heavily burdened with patients who have long term illnesses that take up a dramatic amount of time.

I do not think anyone anticipated the high cost of drugs and medication. If we look at our medical costs today we need to add up not only the costs of hospital care, clinics, family doctors and specialists but the extremely rapidly growing cost of medications. These add to the system as well.

I'm generally of the impression that there are fundamental problems within the modern 'health' system regardless of pay model, and that these inherent difficulties can't (or won't) be resolved within the conventional system itself. But I say this as someone who feels enormously betrayed by contemporary allopathy, so, take it for what it is.

My own GP, who has a positive reputation, wasn't accepting new patients ... I had to phone him at his home and convince him that he wanted me as a patient. I'm empathetic to the problem and the shortage, especially of meaningfully competent physicians. IMO, though, the American strategy isn't producing competent physicians, just hacks, and they spend more per capita on health than we do here and for worse service.

They are fighting for what we already fought for and won but that we are letting slip away. It needn't be so.

[Birdy]

alright.. we all have opinions of what is wrong, why it doesn't work, and what won't work.. but i'm really not seeing a lot of alternatives floating around in this thread.. we're all simply sitting here trying to convince each other of our sides to the argument, without really putting anything out there that could actually serve to convince, or in the least enlighten.. i've tossed some libertarian.. classical liberal stuff out there.. what do you guys suggest? what does the left say will work?

let's talk policy. if you are opposed to two-tier health care, but admit that the current system is in need of reform.. what are your suggestions?

[Diggzz]

The left don't have suggestions, just that whatever the right says is wrong/won't work...

[Birdy]

lol

[d_rawk]

Diggzz, I don't know that that is true.

For one, stopping the flow of public dollars into the for-profit private facilities that continue to spring up (the newest: a BC clinic that will let you in the door for $1,200 CDN, and allow you to see a doctor for $2,300 CDN annually). These facilities eat up the money of the public system. It takes but a modification to the CHA to prevent public money going to funding such places, but it takes political will to make those modifications.

I'm quite open to whatever works. Hopefully, something that works universally.

Among the top priorities:

- ban doctors from working in the private and public systems

- starve private clinics of public money (because they are sucking it out, and then we bitch about funding. Well, that's because you just allowed your healthcare funding to serve as the capital for opening a private business somewhere)

- fund health care so private systems are not necessary (which is quite possible should we take the step above, and also take advantage of economies of scale vis-a-vis pharmaceuticals)

Private health insurance competing with what is provided for by public health insurance will decimate coverage for those who need it. And private health insurance, offered by American insurance companies, is increasingly what they are itching for.

Under our trade agreements, once private for-profit elements are introduced, we legally lose control of the entire system. We are no longer eligible to make reasoned decisions. Spend some time browsing the American health-insurance websites ... the prices are not exactly inticing.

I don't give a fuck about the 'left' vs. the 'right'. I do care about a reasonable amount of coverage for the average person. The demand to opt out of the system by those with private coverage, and the weight of lawsuits from south of the border regarding what will become perceived as protectionism of the public system will be insurmountable.

Exactly what we fought for, collectively, and endured such things as doctor's strikes (during which, interestingly enough, death rates plummeted) would have been for nought.

Shifting the burden of care higher and higher up the economic ladder does not address the fundamental problems -- it just chooses who (the moneyed) are granted access to the resources.

Public money is being co-opted by private interests. That does not need to happen. Amendements to the Canada Health Act can quite easily prevent that by stating it explicitly. That we haven't done that, and that the public system is being starved because of it, is an excellent example of what can be done to preserve what we intended, but ultimately failed, to do.

[Diggzz]

I hear what you are saying and I must admit that i don't seem to have the full knowledge on the subject that you do, but these are problems that have been going on for 15+ years and the solution has always been to throw more money at it, which obviously isn't working (or the money just isn't goin where it's promised/needed). That to me seems to be the Libs only solution to the problem right now, throwing $$$ at it, like the gun registry, it sounds great all this money being pledged but it's not getting the job done.

[d_rawk]

Agreed, wholeheartedly. We're definately on the same page on that.

The Liberals have played the game of cutting money out of the system, and then re-introducing it as 'new investment' without making any hard choices about what needs to be done to actually make the system work.

And even if it were new money, just pouring it in doesn't address the problems at the base. The Liberals have been playing a shell game with us.

[Birdy]

For one, stopping the flow of public dollars into the for-profit private facilities that continue to spring up (the newest: a BC clinic that will let you in the door for $1,200 CDN, and allow you to see a doctor for $2,300 CDN annually). These facilities eat up the money of the public system. It takes but a modification to the CHA to prevent public money going to funding such places, but it takes political will to make those modifications.

[color:blue]i'm 100% for this as well. private facilities which require non-public money for users to benefit from should not be publicly funded.

Among the top priorities:

- ban doctors from working in the private and public systems

- starve private clinics of public money (because they are sucking it out, and then we bitch about funding. Well, that's because you just allowed your healthcare funding to serve as the capital for opening a private business somewhere)

- fund health care so private systems are not necessary (which is quite possible should we take the step above, and also take advantage of economies of scale vis-a-vis pharmaceuticals)

[color:blue]i think you were referring to banning doctors from working in the private sector, which i am totally against as it is in complete violation of free will. if we cannot make private clinics illegal, we cannot dictate where a doctor should or shouldn't be able to work. you're infringing on a basic human right.

i don't think starving private clinics from public funding will really do much good in terms of acting as a deterrent. there is a hell of a lot of money that could be made in medecine, which any bonehead investor can see. the money is out there.. it just won't be coming from a public wallet.

throwing even more money on the pile isn't going to make a positive difference. most lefties on this board comment about the state of consumerism and frivolous spending the americans commit over their thanksgiving weekend and how evil it is.. what makes the frivolous spending of our government any different? as you said in a different post, hard choices have to be made. but why, when we actually had a premier who was willing to make the hard choices (mike harris), did the left so vehemently oppose him? as much as i'm probably going to catch slack for this, i think mike harris was perhaps one of the best things to happen to ontarians.. ever. Probably why Dalton McGuinty hasn't really reformed too much of the Conservative policy, cuz he too AGREES! instead of funding in an effort to keep out privatized clinics, restring the budget within the system, to keep public health care abridge of the same technology that the private system is privy to.

Under our trade agreements, once private for-profit elements are introduced, we legally lose control of the entire system. We are no longer eligible to make reasoned decisions. Spend some time browsing the American health-insurance websites ... the prices are not exactly inticing.

[color:blue]too late.

I don't give a fuck about the 'left' vs. the 'right'.

[color:blue]me either... but there's tons of people who do. people who aren't able to see what the politics of the future aren't as black and white as the politics of the past.

I do care about a reasonable amount of coverage for the average person. The demand to opt out of the system by those with private coverage, and the weight of lawsuits from south of the border regarding what will become perceived as protectionism of the public system will be insurmountable.

Exactly what we fought for, collectively, and endured such things as doctor's strikes (during which, interestingly enough, death rates plummeted) would have been for nought.

Shifting the burden of care higher and higher up the economic ladder does not address the fundamental problems -- it just chooses who (the moneyed) are granted access to the resources.

Public money is being co-opted by private interests. That does not need to happen. Amendements to the Canada Health Act can quite easily prevent that by stating it explicitly. That we haven't done that, and that the public system is being starved because of it, is an excellent example of what can be done to preserve what we intended, but ultimately failed, to do.

[color:blue]withdrawing public money from private interests, restringing the budget to ensure the public system's efficiency, voluntary health care savings plans, and tax deductions can all collectively contribute to ensuring that the two-tier health care system will work in Canada, just as it does in every other developed nation.

more than anything i think the majority of Canadians are in favour of two-tier health care, those who really "need" two-tier health care simply drive over the border anyway. so instead of trying to fix a system that we've been trying to fix for as long as I can remember, let's move into the 21st century and join the rest of the world's developed nations.

Edited December 6, 2005 by Guest

[Birdy]

my quotes aren't working

[Birdy]

hah.. my colours aren't working either.

[d_rawk]

i think you were referring to banning doctors from working in the private sector, which i am totally against as it is in complete violation of free will. if we cannot make private clinics illegal, we cannot dictate where a doctor should or shouldn't be able to work. you're infringing on a basic human right.

[color:blue]Not at all. I know of several doctors who have opted out of OHIP, for example. As I say, I have some misgivings about medical orthodoxy, and if they need to do so in order to operate, then so be it. I am talking about 'double dipping' where a doctor operates within both systems, and thus is able to blur the public funding with their private practice. As far as I can tell from this ...

i'm 100% for this as well. private facilities which require non-public money for users to benefit from should not be publicly funded.

[color:blue]... we seem to agree about this, if nothing else.

i don't think starving private clinics from public funding will really do much good in terms of acting as a deterrent. there is a hell of a lot of money that could be made in medecine, which any bonehead investor can see. the money is out there.. it just won't be coming from a public wallet.

[color:blue]I suspect that with a functioning public system, that this isn't the case.

too late.

[color:blue]Yes, quite possibly. The Liberals have sufficiently dragged their feet that we are likely fucked already.

me either... but there's tons of people who do. people who aren't able to see what the politics of the future aren't as black and white as the politics of the past.

[color:blue]Absolutely. I think that this cuts both ways. Rightist market ideology leads people to disregard the wellbeing of other people, just as leftist infatuation with the status-quo can lead people to ignore the fact that the system hasn't been working. My opinion is that the system isn't working because we've had a government for over a decade that pretends to be an adherent to the idea of universality but is allowing the dismanteling of that system to happen under its watch. From my vantage point, the system is fucked exactly because the Liberals are allowing what you are advocating to happen, and the system would be less fucked if they had the courage or inclination to preserve it. But as we've both agreed on before, the Libs have a lot in common with the Cons, they just pretend otherwise.

withdrawing public money from private interests, restringing the budget to ensure the public system's efficiency, voluntary health care savings plans, and tax deductions can all collectively contribute to ensuring that the two-tier health care system will work in Canada, just as it does in every other developed nation.

[color:blue]I disagree that it works so well elsewhere, and my experience with health forums elsewhere tells me that many an American doesn't think so, either. We are probably at a point where we are about to find out, though. So we'll see, I guess.

so instead of trying to fix a system that we've been trying to fix for as long as I can remember, let's move into the 21st century and join the rest of the world's developed nations.

[color:blue]Nobody has been trying to fix it. One party has been paying it lip service while giving it the finger, and the other has been actively kicking it in the ass.

If I had a dog and never fed it, and kicked it everytime nobody was looking, it wouldn't be doing so well, either.

Nobody has been trying to fix it.

(quotes aren't working for me, either).

[Birdy]

[color:blue]Not at all. I know of several doctors who have opted out of OHIP, for example. As I say, I have some misgivings about medical orthodoxy, and if they need to do so in order to operate, then so be it. I am talking about 'double dipping' where a doctor operates within both systems, and thus is able to blur the public funding with their private practice. As far as I can tell from this ...

okay so no double dipping.. you either work public, or you work private. quite simple.. even in the public system today, if a doctor is that concerned over the actual $$ he or she takes home, they can move to the states where they won't have to. but most choose not to, as a large percentage of them become doctors not for the money, but for the love of medecine and the passion for health. Anyone, doctors included, can certainly attest to the values of the public system and as long as we keep graduating doctors, the public system won't be deemed "second-rate" care. it should be the governments responsibility to ensure that its employees are paid properly for services rendered and by allowing no double-dipping, that's a lot of physician bills that won't be piling up come months end.

[color:blue]Nobody has been trying to fix it. One party has been paying it lip service while giving it the finger, and the other has been actively kicking it in the ass.

If I had a dog and never fed it, and kicked it everytime nobody was looking, it wouldn't be doing so well, either.

Nobody has been trying to fix it.

i'd say mike harris legitimately tried to fix it.

[d_rawk]

i'd say mike harris legitimately tried to fix it.

Wowza. That's scandalous.

I'd posit that even if that were the case, he would have stood no chance, given the deep gutting Paul Martin had given the system as Finance Minister by the time Harris was operating. Funds which Martin later so proudly, and to much fanfare, put back in as though doing so was somehow a new investment.