- Colleen Flood writes that our health care system is more similar to the U.S.' than we'd like to admit - and that many of the most glaring inefficiencies within it are already the result of services funded through private insurance rather than our universal public system:
The latest Commonwealth Study ranked Canada's health care system a dismal second to last in a list of eleven major industrialized countries. We had the dubious distinction of beating out only the Americans. This latest poor result is already being used by those bent on further privatizing health care. They argue -- as they always do -- that if only Canada allowed more private finance, wait times would melt, emergency rooms would unclog and doctors, nurses, patients and the public would all be, if not quite utopia, then at least better off than now.- And Carol Goar notes that the Ontario Libs' spin about a progressive budget is being proven false - promised benefit increases for recipients of social assistance are being clawed back immediately.
(W)hat most commentators weighing in on the health debate don't understand is that we already have a mix of public and private care. What distinguishes Canada's health system from others is not how little private finance we have but how much private finance we already endure. Canadians have their health needs covered by the public system only 70 per cent of the time, much less than the UK (84 per cent) or Norway (85 per cent) or even France (77 per cent).
Indeed, Canadians actually hold more private health insurance than Americans do. How is this possible?
Our health system fails to offer universal (public) coverage for prescription drugs, unlike the coverage provided in nearly every other developed country in the world. Canada also has inadequate coverage for home care and long term care, which are more comprehensively covered in many other health systems, such as Japan, Germany, Belgium and Sweden.
Unfortunately, our health system is more like the U.S. system than most of us know. Just like the U.S., our approach to prescription drugs, home and long-term care is to have some people covered through private health insurance via their employer. Some people covered by governments because they are on welfare or elderly, and a big chunk of the population going without.
The jewel of Canada's health care system is the commitment to restrict private finance for medically necessary hospital and physician care. We don't let our doctors double dip, and we keep essential health services available to all, regardless of means. Yet it is this commitment that is being threatened with the legal challenge in B.C., and blamed for the problems that have beset Canada's health system -- with some pretty clear vested interests ready to profit from the outcome.
Instead of having Canada's health system compete with the United States for last place, we need to start addressing the real issues that plague our system. We could start by looking at the expansive policies of European systems that perform better than our own, starting with a universal health system that includes drug coverage, home care and long-term care.
- Karen Kleiss reports that a Alberta's public-sector pay freeze for senior officials was summarily scrapped as soon as it had served its purpose of offering an excuse to attack other workers' wages. Vaughn Palmer notes that the B.C. Libs can apparently find plenty of money to bribe parents even as they refuse to invest in the province's education system. And David Cay Johnston discusses Chris Christie's belief that public servants shouldn't expect their employers to be honest about what pension benefits will be available for them.
- Meanwhile, Claire Cain Miller makes the seemingly obvious point that improved paid leave can encourage parents to stay in the workforce. And David Cain suggests that we look at different models for our work week rather than one which seems designed to maximize consumption and minimize meaningful activity outside of work.
- Finally, Paul Krugman explains why we should be careful which "experts" we trust to inform us in shaping public policy:
One of the best insults I’ve ever read came from Ezra Klein, who now is editor in chief of Vox.com. In 2007, he described Dick Armey, the former House majority leader, as “a stupid person’s idea of what a thoughtful person sounds like.”[Edit: fixed typo.]
It’s a funny line, which applies to quite a few public figures. Representative Paul Ryan, the chairman of the House Budget Committee, is a prime current example. But maybe the joke’s on us. After all, such people often dominate policy discourse. And what policy makers don’t know, or worse, what they think they know that isn’t so, can definitely hurt you.
Am I saying that the professional consensus is always right? No. But when politicians pick and choose which experts — or, in many cases, “experts” — to believe, the odds are that they will choose badly. Moreover, experience shows that there is no accountability in such matters. Bear in mind that the American right is still taking its economic advice mainly from people who have spent many years wrongly predicting runaway inflation and a collapsing dollar.
All of which raises a troubling question: Are we as societies even capable of taking good policy advice?
Economists used to assert confidently that nothing like the Great Depression could happen again. After all, we know far more than our great-grandfathers did about the causes of and cures for slumps, so how could we fail to do better? When crises struck, however, much of what we’ve learned over the past 80 years was simply tossed aside.
(M)acroeconomics, of course, isn’t the only challenge we face. In fact, it should be easy compared with many other issues that need to be addressed with specialized knowledge, above all climate change. So you really have to wonder whether and how we’ll avoid disaster.