That 800 pound gorilla, again

Take a look at this graphic:

C59W3GpWgAIIdRh.jpg

… nearly 40¢ of every dollar spent in Ontario in 2016/17 is for health care. The other 61.2¢ must cover everything else: roads, the environment, the OPP, salaries, interest on the debt and education. William Charnetski, who, in 2015, was appointed to be the province’s new Chief Health Innovation Strategist seems to think this is a good idea because, he is quoted as saying, “When entrepreneurs hear a figure like that related to any field their eyes should light up with dollar signs … [because] … Ontario needs to win in the knowledge sector … [because, again] … Manufacturing will likely never return to its prominent place as the driver  of Ontario’s economy, and the time is now for business, cities and countries alike to be investing in healthcare.

I actually agree with Mr Charnetski up to a point:

  • Manufacturing ~steel, automobiles, refrigerators, radios ~  will never, again, be the main driver of Ontario’s economy, but that doesn’t mean that the manufacturing sector should be abandoned;
  • Ontario, all of Canada, in fact, does need to “win in the knowledge sector;” and
  • Health care is an important sector of any economy.

So, how do we innovate and “win” in the knowledge sector?

First, it seems rather obvious to me that we should spend more, and More and MORE on education … especially on the sorts of education and training that equips people, young and older, to “win” in the changing economy … maybe as scientists, studying health related issues, maybe as nurses or lab technicians; but, equally, maybe as mechanical engineers, plumbers, accountants, computer graphics specialists, welders and teachers. That, spending on education, keeps getting harder and harder to do as the health care budgets consumes more and more of the available spending at the expense of everything else, including education.

Second, decaying infrastructure, higher and higher taxes, cap and trade energy charges, and skyrocketing energy costs all contribute to the decline of the manufacturing sector and the flight of well paid, low skill jobs to other regions, other continents. And so, I suspect, does a culture that says that we actually need Chief Health Innovation Strategist.

High labour costs, unions and unskilled or even “bolshie” workers are not to blame for Canada’s dismal productivity record. We are less productive, in large part, because Canadian executives are to used to being shielded from the realities of a healthy, competitive market by politicians and public servants who want to try to “rig the game.” Protectionism does not work. It has been seen to be, time and time and time again, a s-l300policy that leads to ruin and even wars … but it is attractive, especially to the political left and the ill-educated, which are often the same, even when being ill-educated means having a PhD. The fact that US President Donald Trump is an avowed protectionist should be enough, in and of itself, to make every thinking person run towards the free(er) enterprise/free(er) trade side. Governments are not good at managing enterprises. There are some things that governments can do well, and a few things, like using force and coercion, that, even if they don’t always do them well, only governments should do. But running businesses or business-like enterprises, like health care, is not one of those things. The private sector, running things for a profit in a competitive marketplace, generally makes better use of all resources ~ fiscal and human ~ to produce better outcomes and lower overall costs.

Third, Canada’s Stalinesque, statist health insurance system is, according to the OECD, higher in cost than most (albeit much lower than the USA’s, and lower than Japan’s and Sweden’s, too) but in terms of our quality and timeliness of care we seem to rank lower than almost everyone except Poland. It needs reform and should not be celebrated as a model for others to follow.

There can be little doubt that the “demand” for health care can and will only grow. Unless we wish to stop repairing roads or educating our children we must find some way to add new money to the health care spending envelope.

1377303517_tumblr_lgpfc1DfU01qeweuno1_500There is only one taxpayer. (S)he, we, must pay for everything from new warships and fighter jets through healthcare and schools to roads and sewers. Nothing is free. There are limits to how much the taxpayers can ‘give.” When too much is asked, or just taken, revolutions follow.

Mr(s) Taxpayer is no fool; (s)he understands that there are different levels of government with different responsibilities, but (s)he expects ~ may soon demand ~ that they work more collaboratively, more efficiently and much more 1998_douglas_stampeffectively to ensure that her/his money is spent well. (S)he also knows that nothing is free, even though (s)he hopes and wishes that Tommy Douglas’ original promise, that none of us should ever face catastrophic medical bills and be forced to choose between medically necessary health treatment and financial ruin, can be true. But we need to explain, to undo years decades of Liberal disinformation, that Tommy Douglas did not promise, in fact likely did not support, a single payer system because he knew ~ being a provincial premier who actually delivered balanced budgets ~ that users could and should pay something for services rendered.

It is, I suspect, intuitively obvious to Mr(s) Taxpayer that “somethings gotta give” before healthcare costs deny families everything else that they need and want.

The current system imposes a financial straitjacket on provinces. The restraints need to be loosened, preferable removed, entirely, so that each province may experiment with how to best fund healthcare as part, but only one part, of the entire spending package for everything from school books to highways. We, all Canadians, should want and indeed demand a healthcare system that delivers what Tommy Douglas promised: that we all pay something but that no one needs to be ruined by medical bills.

In my guesstimation some, likely a lot, of new, private (most likely insurance company) money is downloadneeded. But that, business and free enterprise and markets and profits, not health care, itself, is the 800 pound gorilla; that’s what a Marxist narrative, that has been in place since the Canada Health Act was adopted in 1984, has made anathema to too many Canadians and that’s what a real leader has to defeat before (s)he can tackle the more manageable problems of “ways and means.”

 

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