… to use the tragedy of a death to make a point, but this CTV News story angered me. Four women, all women of colour, too, from just one union, have died as a result of contracting COVID-19, almost certainly while all four were employed as personal support workers or in Long Term Care Facilities. They are the very people Premier Doug Ford has, very correctly, called heroes. I asked, a couple of months ago if we wanted Long Term Care for our elderly or if all we would (could afford to) do was to pay for Long Term Storage. My guess is that all we can afford is storage and even that depends on being able to pay good women ~ most of the people who do these hard, thankless jobs are women ~ like the late Maureen Ambersley far less than they are really worth.
The problem, as I have said before, is that the Canada Health Act locks provinces into a health-care funding model that is unsustainable.
Having another commission of inquiry isn’t going to change that truth. The Organization for Economic Cooperation and Development (OECD) a “club” of the most developed countries says that Canada is a big spender on health care:
But the same agency says that our health “outcomes” ~ like wait times for an appointment with a specialist or surgery ~ are pretty poor. We spend more than most (not all) comparable countries and we get less in return.
Simply spending more is not going to fix anything. Canadians have to spend more wisely and they have to better sources of funding. Now, when a service is public there is, generally, only one payer. In the 1980s then Prime Minister Pierre Trudeau and Monique Bégin, his health minister, wanted a totally public health care system: publicly (government) owned and operated hospitals would treat everyone, at not cost to the patient. Doctors would, eventually ~ sooner they hoped rather later ~ become public employees. “From each according to his abilities, to each according to his needs,” was to be the guiding principle. It sounds familiar, doesn’t it? Marx was wrong. Marxism doesn’t work. Those who believed in and tried to practice Marxism in the 1970s and 80s were stupid people, as are those who still tech Marxism in Canadian schools and universities today. The Marxist “solution” of the 1980s didn’t work then and still doesn’t work today. It needs to be replaced.
The best health care systems:
- Are Universal ~ everyone has some health insurance AND no one is turned away from clinics or hospitals when they are in need or care;
- Are Portable ~ on can carry their health insurance with them across interprovincial and even across many international boundaries;
- Protect people from catastrophic health care costs ~ that, we must remember is what Tommy Douglas promised. he did’t promise “free” healthcare. As a successful provincial premier who delivered several balanced budgets he knew that was impossible, but, as an “ordinary,” middle-class kid of guy he also knew that health care could cost big money and that few families could afford it; and
- Are a Public-Private Partnership in which physicians in private practice work with a mix of public and private hospitals and clinics, including group practices and community health centres, to provide the full range of general and specialized car to all who need it.
In the best system everyone is responsible to manage their own individualized mix of public (universal) and private health insurance. We will likely have some sort of either a pubic or a private ‘healthcare savings account‘ into which we, or our insurance provider, will pay regular instalments which will cover routine treatments and certain hospital benefits, like private rooms, etc. Some, a few, will be totally reliant on the public system: they will face long queues for non-essential services. We will all be responsible for paying for routine health services like medical checkups and emergency visits to a community clinic or health centre. A very few people will always fall through al, the cracks and they will never be able to pay anything. That is where we, the taxpayer will step in ~ we will, after (s)he has tried two or three times to collect what’s owed, pay the physician or physiotherapist or pharmacist for the service that (s)he provided to an indigent person.
Don’t think that just because the best healthcare system has “new money” from private payments and private insurance that it does not need public support ~ i.e. your tax dollars and mine. What Tommy Douglas promised, protection from catastrophic expenses, will still be mainly a public responsibility. Many of us will have private insurance plans ~ either paid by ourselves or by our employer ~ that will cover some and in some cases all of even the highest bills. But many of us will not and yet I am 99% certain that almost none of us wants those who do not have adequate private insurance turned away and then made destitute by sky-high medical bills. That is when we, as members of a society, agree that we will each pay a little so that no one is faced with paying so much that face medically-induced poverty.
What about the late Maureen Ambersley and the people she served, those in long term care? Long term care is getting a lot of well-deserved attention lately. How can we make it better for most people? The answer, I think, is a mix of major healthcare and employment and immigration policy changes that make it easier to hire more willing people ~ willing to do hard, menial, often dirty work ~ for low but fair and decent wages. That means that the operators of long term care facilities need to pay better wages for good people and that means that we may need to allow more willing people to enter Canada to work as care-givers and as cleaners, too. It also means that the tax system needs to make it easier to pay better wages to good people for necessary work. It ought to be “better” to be a personal support worker or janitor in long term care facility than to be a server in a fast-food restaurant. It must be “better” to be either, or to take any honest job, than to depend upon social assistance.
Canada needs to rethink the policies that made Ms Ambersley’s situation ~ working, most likely, in an understaffed and not always medically safe environment ~ possible, even probable. That “rethink” starts with changing th Canada Heath Act so that it frees Canadian provinces from the chains of Marxism.