Tag Archives: Students For Medicare

Debate should be about better public care, not defending status quo

Dr. Danielle Martin speaking at the Students for Medicare conference April 27.

Dr. Danielle Martin speaking at the Students for Medicare conference April 27.

Dr. Danielle Martin calls it a “trap.”

Opponents of Medicare argue that privatization or two-tier health care is the answer to the problems that face Canada’s health system.

The trap is to get caught defending the status quo in that debate.

Chair of Canadian Doctors for Medicare, Martin argued at Saturday’s Students for Medicare conference that we should be advocating for a better public system, not defending one that shows mediocre results for what Canadians are spending.

“Who thinks long waits are acceptable?” she asks the room.

Martin argues that what is driving cost is not aging or population growth, but increased utilization of the health care system by all ages.

“More docs, diagnostics and drugs – are we any healthier as a result?” she says.

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Austerity amid incredible wealth — Yalnizyan

Economist Armine Yalnizyan reminds us that the present call for austerity is taking place amid a period of incredible wealth.

Speaking at a Students for Medicare Conference in Toronto March 31st, the Canadian Centre for Policy Alternative economist said this debate is taking place amid a backdrop of growing income inequality.

“We’re standing in the middle of the industrial revolution,” she said. “Global wealth is expanding exponentially. We have more access to stuff than ever before.”

Economist Armine Yalnizyan speaking at the Students for Medicare Conference March 31.

While the rich were also affected by the economic crisis of 2008, having lost on their investments, she says they have bounced back much faster than the rest of us.

There is a growing consensus among major institutions – including the Bank of Canada — that growing inequality is a major problem.

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Guyatt: Want sustainable health care? Go public

Why is it we celebrate the production of 10,000 SUVs or 10,000 television sets as economic growth but don’t do the same for 10,000 hip replacements?

Dr. Gordon Guyatt points out that there is likely more merit to the hip replacements than the SUVs, yet we are conditioned to think otherwise.

Dr. Gordon Guyatt

Dr. Gordon Guyatt

Public health care is not a drain on the economy, but part of the economy.

Speaking at a “Students for Medicare” conference in Toronto March 31, the McMaster University professor and recent recipient of the Order of Canada made the case that the road to sustainable health care is in publicly funded health care.

Guyatt was critical of the mainstream media who only look at the sustainability of public health care costs, ignoring total health care costs.

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Guyatt and Yalnizyan speak at free one-day conference March 31st

Internationally respected health researcher Dr. Gordon Guyatt and Economist Armine Yalnizyan are the featured speakers at this year’s Students For Medicare conference taking place March 31st at the Cecil St. Steelworkers Hall in Toronto.

Guyatt will be speaking about the public-private debate and what it means in today’s economic climate. Guyatt was recently appointed an Officer of the Order of Canada for his work on evidence-based medicine and its teaching. A professor at the department of clinical epidemiology and biostatistics at McMaster University, he is also an active spokesperson for the Medical Reform Group and sits as a board member of the Ontario Health Coalition.

Yalnizyan will be looking at the climate of fiscal restraint and its impact on health care. Yalnizyan joined the Canadian Centre for Policy Alternatives in 2008 and is a regular panelist on CBC’s Lang and O’Leary Exchange. She is also one of the most read contributors to the Globe and Mail’s Economy Lab and is a founding member of the Progressive Economics Forum.

Participants can also take their choice of several small group sessions on emerging issues in Canada’s health care.

The conference runs from 10 am to 2:30 pm and includes lunch.

Registration begins at 9:30 am.

While the conference is free, you should register in advance by clicking here.

Sustainability panic unwarranted says Rachlis

Dr. Michael Rachlis speaking to the Students For Medicare conference May 28.

Dr. Michael Rachlis wonders about the credibility of the scary health care scenarios painted by former Bank of Canada Governor David Dodge and TD Economics’ Don Drummond.

Dodge and Drummond have authored reports suggesting that health care spending will not be sustainable unless dramatic changes take place.

Speaking to a Students for Medicare conference May 28th, Rachlis questions the ability of Dodge and Drummond to do 20 year projections when “they don’t even have this year right.”

As a percentage of our total economy, public spending is up by 0.6 per cent since the last recession in 1992. Private spending – through private insurance and out-of-pocket health expenditures – is up by 0.9 per cent.

Rachlis has been particularly critical of Dodge, who appears to be deliberately ignoring data from 2010 which shows health care spending in decline relative to the size of the economy.

While Drummond and Dodge have suggested solutions may emerge in greater private involvement, Rachlis says the numbers show that public spending is much more controllable than private.

“In a multi-payer system companies can take advantage of the fact that people will have less purchasing power,” he said.

Looking across Canada, Rachlis says that if Alberta were a country it would be spending less than any other industrialized country in the world.

“Yet they are screaming they don’t have health care sustainability either,” he says.
“In Quebec their spending has remained flat for 30 years, and yet they are subject to the same hysteria.”

Even as a percentage of government program spending, there is little to suggest that health care costs are unsustainable – most of the growth related to a shrinking revenue base through tax cuts. In the early 1990s government spending accounted for 53 per cent of the economy. Just prior to the recession it was below 40 per cent. Government revenues has fallen by 5.4 per cent relative to gross domestic product (GDP) in the last decade, adding up to a loss of $90 billion.

“None of that money has gone to any of you in the room,” he says.

With half that amount we could implement pharmacare, national child care, deliver free university tuition, and still buy the fighter jets.”

“We have made a choice, but not a deliberate choice,” he said.

Both Dodge and Drummond show a sudden surge in their charts where the spending line heads 45 degree upwards, consuming between 70 and 80 per cent of provincial program spending.

Rachlis says he doesn’t understand how they arrive at this figure. Since 2003 spending as a percentage of overall provincial program spending has remained flat at about 39 per cent across Canada.

Rachlis warns that Tony “Huntsville Gazebo” Clement is promising to cut public spending further, even though Canada and the US spend almost equal amounts on public services as a percentage of the size of their economies.

“The Canadian public sector has never been smaller than the American,” he said.

Dispelling the myth that aging will escalate costs, he says aging “is like a glacier, not a tsunami.”

While health care spending is hardly out of control, Rachlis believes there are better ways to organize our present system to make it more effective.

“Our system was designed for acute illness. Our main problem is chronic disease.”

Canada also lags behind most developed countries in advanced electronic health information capacity.

“You grow up with computers and you get to health care and you are dealing with pieces of paper,” he says.

Canada also does badly in after hours care to see a doctor or nurse, and especially long waits to see a specialist.

“The original vision of Tommy Douglas was perfect,” he says. “Due to compromises, we never followed through.”

Rachlis says the solutions are in integrated health care delivery, group medical practice, and democratic governance.

He warns that the present Federal government is intent on getting out of health care altogether, leaving it to the provinces.

The 2004 Health Accord gave very little guidance on how Federal money would be spent, it being about more funding than how the system would be organized.

“If we are prepared to think outside the box, we can fix Medicare through innovation,” he said.

The first stage of Medicare was to eliminate financial barriers. The second stage was meant to deliver services to keep people healthier.

“That’s the real road to sustainability,” he said.