P.M. Jaworsk notices that the New York Times is reporting on an important case that no one in the Liberal wing of the Canadian media seems to want to touch;
[T]he article, entitled “A Doctor-Lawyer-Gadfly v. Canada’s Medical System,” is a good account of Chaoulli’s struggles and battles with Canada’s health care system. That struggle has been temporarily put on hold, since the Court has not yet issued a ruling in the case. (Chaoulli finished his arguments almost a year ago…)
In my article, scholars that I spoke to expected the decision to come down before the end of last year. Why the delay? No one really knows for sure, but Chaoulli told me that he sees it as a “good sign.”
The NYT article is online though you will have to register (free).
A diminutive man who has trouble keeping his wire-rim glasses on straight, Dr. Chaoulli, 53, hardly looks like the “freedom fighter” that Canada’s conservative news media have called him. But if he wins his case he will tear up the third rail of the nation’s politics and raze what many Canadians consider to be the bedrock of their national identity.
He argues that regulations that create long waiting times for surgery contradict the constitutional guarantees for individuals of “life, liberty and the security of the person,” and that the prohibition against private medical insurance and care is for sick patients an “infringement of the protection against cruel and unusual treatment.”
He believes that Canada is disallowing the basic contract rights of doctors and patients, and that the country would serve the sick much better if it had a parallel private health care system, as in France and many other industrialized countries.
“His argument is credible,” said Patrick Monahan, dean of the Osgoode Hall Law School of York University in Toronto. “The issue of waiting times does raise constitutional issues.”
Check out the Western Standard article from last year, too.
Seriously- is anybody surprised by this? Name me one single Federal Government department in this country that actually knows what it is doing, and is not tainted by scandal and incompetence! The present and former government could not possibly tolerate having a competent person in cabinet- they would be shown to be the simpletons that they really are!
If the Supreme Court is waiting for political calm to ensue before releasing their ruling, we might be waiting a few years. And I find it hard to believe that the Supreme Court of Canada is a political body./sarc
Why is nobody on this? We have to read the NY Times to hear about it?
I think I was more shocked that it was in the NY Times. A leftie paper…. strange..
20 May 2005 Canada.Com News carried this headline:
“P.E.I. government tables legislation to reform health care system.”
Can you imagine what an impact such a headline would make if instead of P.E.I. it read “ALBERTA”?
This whole health care debate is nothing more than political hype.
Jeez.
I know, I’m just another American morbidly curious about life North of the Border, and I’ve always heard Canadians pride themselves on tolerance (How does a Canadian change a lightbulb? He doesn’t, he accepts it as it is).
But seriously, how can you justify this?
“…the case of Georges Zeliotis, a chemical salesman with recurring hip problems who was forced to wait a year for a hip replacement while prohibited from paying privately for surgery. Mr. Zeliotis could have gone to the United States, but since he was also forbidden by Canadian law from purchasing private insurance he would have been forced to pay out of his pocket, which was beyond his financial means, Dr. Chaoulli said…”
Is this at all common? A Canadian-someone must suffer for a YEAR, and be forbidden to take action that could address it?
What is the a reason for prolonging human suffering? National pride in “free” health care?
Mike Coan,
Yup, we keep getting told it’s the “Best” system in the world, the feds take great pride in there health care act.
/sarc off
God Bless Our Socialist System!
I’ve often wondered why Canada went with the exact system it has rather than some type of nationalised health insurance with private practitioners. Everyone seemed happy at first but the baggage that comes with such a system should have been obviouse to the implementers. Of course the big problem the US has is the high cost due to the lawyer feeding frenzy. There is hope that eventual tort reform will correct a lot of the problem (ever notice when things are screwed up there’s a lawyer in there making money hand over fist?:)
I believe the original healthcare plan was an NDP idea implemented during the 60s when there were lots of minority gov’ts so lots of negitating between parties.
My biggest issue with the NDP is their “chicken in every pot” mentality that promises eutopia but doesn’t have any underlying common sense in delivering on the promises. Which might explain how our poorly-designed healthcare system is so bureaucratically mangled.
OT
LOL… Belinda getting slammed:
http://turncoatbarbie.com/
The evidence (which likely will never become public) will be very damning but there is not much hope that the liberal judges will rule against this bastion of our socialist state. What likely will happen is the ruling will narrowly favor medicare which will fly in the face of the Liberals and NDP election campaignin, assuming there is an election any time soon.
Did not socialized “sickness” care in Canada start in Saskatchewan by Tummy Dooglas? This socialist idea then spread like the plague until the Liberal/Socialist regime in Ottawa realized it was a perfect Socialist ploy to further the cause of National Socialism. PM Martin goes himself to a private doctor’s clinic in Montreal. That is the rotten truth re socialized “sickness” care in Canada.
More re Cuba:
Nealenews.com reports Castro’s secret police crackdown on democracy campaign.
Cuba has “Free” “Sickness Care” for its people/prisoners just as does Canada.
Down with National Socialism.
Long live freedom and democracy.
Hey, we do have access to private healthcare, just take a drive down to the States. The medical system there is also much more forward thinking and embraces alternative medicines. It is not unusual to see a naturopath with a full supply of herbaceuticals right next to the OBGYN. Bring your VISA card.
The press has finally taken Bozo Paul and Bimbo Belinda off the front page for a more important photo of Saddam in his BVD’s. They’ll weep and wail over this blaming George Bush. How relevant is our media? none,zip,nada……….. CBC home page you can link to an in depth report on Canada’s newest(Chief Thief) cabinet member. Boogles the mind for there is no depth there, there……..
Hmm question. I just realised when thinking about our own corpse feeding lawyers…how are cases of seriouse (factual, documented, blatant) malpractice handled in Canada? What is recourse for the effected person? Who pays or is it just “touch s**t, you’re gonna die!”
Now I do believe there should be recourse when normal mistakes are made (not unforseable circumstances outside the control of the doctor) recourse within reason. But a blantantly stupid doctor should get slammed
The Canadian public health care system worked very nicely years ago – not perfectly, but very nicely. It improved the overall health care delivery for the majority of Canadians. However, it is painfully clear that the system has deteriorated, due in no small part, to the fact that it was sacrificed by the Federal Govt in order to tame the deficit. You will recall who initiated that situation – I believe the name Paul Martin comes to mind.
In any event, the Provinces scrambled to deal with radically reduced funding and slashed whatever they felt they had to in order to try to continue to run their health care programs. Some truely wacky things were done in the name of fiscal responsibility – things like firing nurses and hiring more admin people, etc. Suffice it to say that things degenerated to their current form.
Clearly the current chaotic situation needs to be dealt with. In terms of private healthcare insurance and an entirely private healthcare delivery system, I would have to STRONGLY caution against that. I have been involved in the International health insurance business for a number of years and I can tell you many stories that are not pretty. However, having said this, when public health care is no longer meeting the needs, how can you possibly bar people from seeking the solutions that will relieve pain and preserve life? Where the public health care system cannot deal with a situation, how in God’s name, can you expect people to sit and wait in pain for their number to come up, or maybe to wait til they die??? Unless and until the public healthcare system can provide medically necessary treatment in a timely manner for all Canadians, authorities have no right to prevent people from seeking private healthcare solutions.
As you can see, I am not a strong supporter of either extreme of ideology. I say, let the private providers in and pay them from the public purse. In the short term, that will help to deal with the problem. If Govt is unwilling or unable to restore our healthcare systems to some level of efficiency, then we will have to go to the European model – a mix of public and private healthcare facilities, financed by public health insurance. What we CANNOT do is continue to dither and make no decision whatsoever, thereby preserving the status quo.
WildRose…
I have worked in both the US and Canadian health care systems. Neither is ideal. In the US, if you have good insurance, you will get the best health care in the world bar none. If you don’t well, that is the issue.
There is also the buyer beware factor regarding health plans as well as the “pre-existing condition” barrier for many. Also it is a paperwork nightmare for both providers and institutions.
But, the scare tactic that is often touted in Canada about the evils of the US system relates to the uninsured and indeed it is a big problem. However, a little known fact in Canada is that NO health institution that receives federal funds in any way can refuse to deliver care to someone who needs it. And virtually 100% of health care providers do receive federal funding in one way or another.
Furthermore, if you tell an American he or she is going to have to wait months-to-years to receive care, they will simply go elsewhere, even if it means travelling somewhere esle in the country.
Now on the Canadian side of issue, delivery costs have been controlled buy reducing access/facilities/services and having people wait. This has not, however, reduced the accelerated pace in the addition of various numbers and iterations of regional health boards and hospital administrators, many of whose qualifications for their roles are limited at best and most of whom are appointed by political means.
In addition, the system is never put to the test to determine if additional administrative costs are offset by improvements in access and quality. Most if these folks are “clients” of the government and have been added to the “indexed pension” roles as well.
Canadians need to be much more open minded about allowing experimentation with private options. The principal difference being that the private providers need to watch their costs so they don’t loose their shirts. In contrast, the public system has no such incentive to be productive or cost-effective. None of those administrating the system need to worry about where their next meal is coming from.
This is obviously a very complex issue that one cannot to justice to in the context of blog comments. Just some obervations and thoughts
I have a herniated disc. I have had it for a year with the resulting sciatic pain. My doctor just contacted a neurosurgeon in Calgary for me. They sent me a letter saying they will set up an appt but its a six to twelve month waiting list.
In the meantime I found a website, it may have been through Kates blog, but I am not sure. Its called Timely Medical Alternatives. I emailed them and ask them the cost of this particular surgery, thinking they would get me a price in US dollars. But no, I was told I could get the surgery done in BC at a cost of between 75 to 95 hundred dollars and no waiting list. Now I am wondering if Alberta Health care will cover the cost. I doubt it but, wouldnt I be moving someone else up in the line in Calgary and what difference if I have the surgery here or in BC. Its all Canada isnt it?? I am gonna contact the health region for this area and see what they say. I am told it doesnt look good.
oltx,
You bring up a number of good and valid points on both types of systems. I do agree that Canadians need to be more open minded about solutions to our healthcare issues. The problem is that public healthcare in this country is a political football and has become highly emotional for some. It’s difficult at times to have a rational, factual and open minded discussion about these issues in an environment of mis-information and scare tactics. And yes, it is too complex an issue to explore adequately in a blog, but did appreciate your comments.
One more comment on the relative costs of the 2 systems: information from our health claims managers shows that when we are arranging care for someone regardless of what type of PPO discount we can get through any of our US providers, it is always cheaper to have the procedure performed in Canada. (There actually are a few facilities in some of the big Canadian centres that have some capacity to do out of country patients.) Further, Canadian providers can charge a higher price to out of country patients than to Canadians. This body of information tends to indicate that, regardless of the inefficiencies in the Canadian system, health care here is still usual lower cost than in the US.
MikeP: all the best to you in getting your situation dealt with. I would certainly see if Alberta will pay for it – what have you got to lose?
Paul Martin’s doctor runs private clinics: Medisys.
http://www.paulmartintime.ca/mediacoverage/000476.html
*************************************************
Medisys:
Named as a director is Senator Leo Kolber, Liberal. However, Leo Kolber is a retired senator. Why is he called Senator Kolber on the site?
http://www.medisys.ca/en/co-board.htm
************************************************
Paul Martin – Blind Trust:
Contributions collected in a Blind Trust includes:
87215 Senator Leo Kolber $10,000
87215 Senator Leo Kolber $50,000
Google: Enter: paul martin blind trust
Look in “Cached” for html
************************************************
PM Martin says he is the defender of Health Canada.
Paul Martin is a Socialist & full of BS.
maz2
Just to review recent history, it was Paul Martin’s fiscal policies that percipitated the current crisis in Canadian health care, not that it was perfect before.
And technically, I don’t think he’s a socialist (going back to my old Political Science classes) because there is actually a cohesive ideology attached to socialism. I just think he’s power hungry and willing to do anything to stay in power. There is a line between sharp policial gamesmanship and illegal / unconstitutional behaviour and IT’S BEEN CROSSED!!
Here is another blogger who has left the Liberals, aka The Dark Side:
http://www.dailyakrasia.blogspot.com
Give him an instalanche to show support.
Highlight him and harperliberals.ca with a Sunday Edition. Dare you, SDA!!!!!
Found him in comments at harperliberals.ca.
Dare to be a Daniel.
Wildrose…
There are several reasons why US providers “bills” are higher for Canadians.
First, because of the high level of service they provide, the technologies, the rapid access, the skill levels, their relative cost-base is high.
Second, reimbursement, especially from US medicare is low and often does not cover costs.
Third, most instituions employ a payer case-mix formula to try and remain in the black when balancing below-cost payers with above-cost providers, all done to maintain volumes and core competencies.
But forth and most importantly, most US providers look to “foreign” patients as a source of “big” supplemental revenue and often charge in excess of 200% of what they would charge for US consumers.
I have no doubt that private systems in Canada could provide higher standards of access and quality at lower costs than the current monopoly-based public system.
Many years ago I was looking at a job in a major US center. The institution in question had about the same number of beds as my then Canadian counterpart. And yet it managed to provide more than twice the number of surgeries and services per annum. But perhaps more impressively, it had but 1, yes 1 administrator and that individual was also a practicing MD. In contrast, the institution in Canada at which I was based at the time, with about the same physical plant and doing half the level of service, had no less than 12 vice-presidents in its administration.
So from my perspective, step one is to reduce/eliminate those on the “indexed pension” pathway whose presence contributes little or nothing to the delivery of the product. They should begin by eliminating sequentially these positions and see if there is any effect on quality or outcomes. Provided service levels do not deteriorate from their already sub-standard levels, just keep going and trim the fat.
Unfortunately this will never happen in the Canadian system because those who now make the rules have one which overrides all others. He or she who has the gold makes the rules and there is no way that these folks will act to eliminate themselves.
Therefore the only realistic option is to explore private alternatives. I have no doubt that in any objective head-to-head comparison of cost-effectiveness, access and quality, the privates would win hands down.
Many of Canada’s institutional problems (health care, education, corruption, etc.) could be solved by cutting off bureaucrats. It’s not unheard of to have as many administrators as actual health care providers, for example. Chop off the former and hire more of the latter.
A bureaucracy is like a living organism, it always tries to grow. And due to our socialist rules, it’s impossible to fire people when they are no longer needed (or just plain doing a bad job).
What we need is a one-term government that will be willing to go down in flame (bureaucrats are voters too) and make drastic cuts across the board. Not going to happen, but that’s what we need.
I would agree that the right to life and quality of it would be infringed under s. 2 but
it would have to stand the test under s.15
equality of protection and benefit of the law.
weigh in – those with more money able to buy medical services quicker do and free up the public system for those who cannot afford private health care. That being said, it is also way oversimplified and does not take into consideration the various scenarios of delivery and possibilities of creating more harm than good.
It takes quite awhile to weigh these factors in and each province has it’s own way of running it’s own health care system ie funding, colleges, teaching, training etc…thus, adding more scenarios
In Ontario Charter rights are often ignored anyway even though they are supposed to be protected under s. 32
Harris tried this with some services in Ontario. One company took the money from the government and went bankrupt 2 years later. The government did not check their investment before putting their money on a privately run health service.
If implementations are imposed too quickly then there will be inevitable persons who have their Charter rights violated. The issue is, whose will it be? Those with money, or those without? It most likely would end up like our justice system, with rules, law and penalties and legal services for one group of people and for others another. It all looks legit on paper and in theory, but in reality, it isn’t
Mike P…I got my MRI in 2 weeks for a suspected slipped disc which turned out to be degenerative arthritis…I have been in pain for 5 straight days because I choose to walk longer than I can or because I’ve sat to much commenting on these blogs…I feel like I need a walker or a cane to get up sometimes and I’m way too young. It’s great to be diagnosed, but there is no pain management care…life in pain can suck sometimes
I guess quality of health care depends on the region, city and province. It’s run differently even by each hospital. At least now in Ontario
the auditor can look at each hospital’s books and services based on value for money and other auditing tools. And this just started in April of this year after years of corruption and waste by hospital managements in Ontario!
I know that a big problem with the US system is the lawyer feeding frenzy any time something goes wrong. Hopefully tort reform helps the costs, without eliminating recourse for incompetent doctors.
Canadian health care, however, just sucks big time. My wife has had symptoms of MS for years. 3 years ago, after waiting months to see a specialist here in Saskatoon, he told her to take some aspirin. He stopped short of telling her she was wasting his time. After explaining her symptoms to him, she asked if they were normal. His answer, “what’s normal? who can say what is normal or not. Maybe you should take some aspirin and see if you feel any better”. Fuckin ass. What recourse have we got here in Canada?
Of course getting a second opinion took another year, as there is only one other specialist available here. The only thing that was quick was the MRI. Our neighbor works in the system, so we were able to reduce the wait time from 4 months to less than a week. Kate if you ever need an MRI, let me know, it helps to have connections.
Anyways, is that the way our system is supposed to work?
Interesting note on the MRI scheduling. The staff have been pushing for a while, and have reduced wait time in Saskatoon significantly by using a little common sense.
1. You can get on a short list and get called when someone else misses an appointment (like when they died already). this only took about three years to implement.
2. They are now taking evening visits, as they finally have enough staff to operate longer hours, although many customers complain about the fact that they have to come in at 6:00 PM, poor babies.
Funny how that works. Working in private industry, it’s automatically assumed that if we are going to invest $1 mill in capital assets that it better damn well be working more than 1 shift.
Now the fun part. Medication to slow progress of MS costs about $1500 – $1900 per month. (my private plan covers 80%, which still leaves us with a $300 -$400/month bill) We have submitted to the Sask gov’t for financial assistance (which we are told is available), but it depends on our income. As I have managed to climb up to the top income tax bracket, is anybody willing to bet that we will get assistance? Gotta love a system where the more you pay, the less you get.
Habamus – get to the healthfood store and stock up on both glucosamine & MSM. It will make a HUGE HUGE difference (glucosamine does in 70% of patients, not sure on the stats for MSM but I think it’s higher).
Also phone the local universities (ideally the one attached to a hospital) and find out who is doing pain management studies. I know my doctor here is involved in that with the UofA. If you want, email me & I’ll see if he knows of someone in your city.
The problems in the Canadian and US medical systems are both “made in government”. Who ever heard of insurance for routine expenses, like doctors checkups? Does your auto insurance cover oil changes and brake inspections?
Read this if you want to dip into the socialist history of American health insurance.
If Canadian public health care appeared to “work” for a few years after it was introduced, that’s because it took a while for (a) patients to realize that they could show up and get free care 24/7 for every little cough and sniffle, and (b) doctors and other health workers to realize that medicare was a cash machine with no limit on withdrawals. You also had a trickle then a stampede of government hangers-on such as bureaucrats, architects, engineers, contractors, lawyers, accountants, etc. grabbing obscene amounts of cash from ill-conceived and wasteful hospital projects. Every one of which was launched in the name of “efficient” health care delivery.
oltx:
Had to go out for a while and just got back to see your 9:58 pm post.
In the US, the Medicare system has imposed stringent limits on the fees they will pay for procedures to the point where fees do not cover the cost of services. As providers are not able to bill patients for the shortfall, they do not break even on Medicare patients and thus seek to charge higher fees on out of country patients in order to bascially subsidize their Medicare patients. It should also be said that many US providers do feel some onus to provide treatment for Medicare patients even knowing that they will go into the red on them. You mention a multiplier of 200% for fees on out of country patients – my figures also indicate 180% to 200%, dependent on the particular provider.
I have also noted a significant variance in fees on the same procedure between providers in the same area. Some of these variances could only be explained as “brand name” pricing – well known doctors who simply felt they could charge more. In an environment where fees are not regulated by the government, you will see this sort of thing happening at times.
In terms of administration,I completely agree that Canadian hospitals could certainly use a healthly dose of functional ratonalization – we have added fat that does not contribute to the product! As you suggest, dare we hope that bureaucracy can possibly police it’s own growth? not likely, but this would have to be a “top down” process, just as it was when rigorous budget cuts were imposed in opposition to concerns about quality of health care.
With regard to your example of the US hospital with 1 adminstrator, in order to look at the whole picture, we would need to recognize that private hospitals must employ an accounting dept in order to maintain the more complex billing and accounting processes for private practise. This too will add an administrative layer.
The balancing act in the private health care industry is between cost effectiveness and the delivery of quality health care. Let me say that there are documented instances of transgressions on both sides of this equation – can be a tricky act.
We Bananny state Kanadians should be proud we have such a caring government that it has its state controlled media clip all the “naughty bits” out that we shouldn’t read. Sometimes the truth will make you sick…and we don’t want a lot of sick people with this welfare state health system.
If state pravda doesn’t print it …it don’t exist….so by that standard we are lead to believe that Trudaupia is prime health…no sick, no poor, no injustice…the perfect kleptocratic utopia…at least that’s what the TO pravada sez.
Almost missed it
Kate at SDA linked a story in the NYT about a Canadian doctor who’s arguments before the Supreme Court of Canada are based on the idea that long waiting lines for medical treatment violate the Charter rights to life, libery…