Solving the Health-Care Crisis

The Commonwealth Fund’s annual health policy survey has ranked Canada very poorly among 31 high-income countries with universal health care for timely access to services.

How to fix our health-care crisis?

The obvious first move is to abandon the odd political shibboleth that we must not permit private care. “No two-tier health care.” Why not? Canada is the only universal-care country that severely restricts private options. In Britain, the rich are publicly shamed if they resort to the public system.

As a practical matter, the Canadian rich currently often head down to the States for private care. This is an unnecessary travel expense for them, and it drains money from the Canadian economy.  Better to let private firms set up in Canada. The rich will be able to “jump the queue,” but as a result, the queue will be shorter for everyone. To object is mere self-destructive envy.

Then if a privately-run clinic or hospital can provide a service for less than the public system does, as may well be the case, the government plan too should cover the private option. 

Most of what doctors do, however, is diagnosis, and prescribing pills. AI can already diagnose and prescribe more accurately than a human doctor. Accordingly, we need much less training than we currently demand for a medical doctor; all we really need is basic computer competence. We need nurses, dispensing pharmacists, and technicians to run the diagnostic machines. We do not really need doctors.

We should also institute a nominal fee, a deductible, for a doctor or hospital visit, to discourage unnecessary use: say $5.

And we should not cover unnecessary non-health procedures like sex changes or abortions.

On Canada's Pressing Need to Track More Health Data

 

“among advanced OECD countries, we are 31 out of 34 in acute care beds per thousand population, 26 out of 31 in medical doctors and 17 out of 32 in nurses….We have 10 times as many health administrators as Germany although Germany has more than twice the population of Canada.“

--Fraser Institute, quoted by Conrad Black, National Post.

So why is it that the Trudeau government sees the first priority to be imposed on the provinces as improving the tracking of medical data?

I have a guess.

See below.

How to Improve Health Care

 

My remarks from a recent all-candidates meeting in Beaches-East York.

The question was what I and New Blue would do for health care in the province.

First and immediately, we need to rehire all the health care professionals laid off because of their vaccination status. It is not a good idea to fire doctors and nurses in the middle of a pandemic. 

And it is not following science to insist that health professionals are not qualified to make their own health decisions. We should be listening to them, not firing them.

We have known since at least September that vaccines do not prevent people from getting COVID. They only reduce symptoms. We cannot achieve herd immunity through vaccination. 

There are only two possibilities here. If vaccines work, there is no need to care whether someone else get vaccinated. You’re vaccinated, and you’re safe.

But if vaccines do not work, there is no case for forcing others to get one.

Vaccination is a personal choice.

New Blue wants an end to all vaccine mandates. It wants to prevent vaccine passports. Both are violations of the Charter of Rights and Freedoms. Brian Peckford, one of the authors of the charter, is suing the government now over this.

There are other steps we could take to ease the shortage of workers in health care and in long term care. 

There are many dedicated, well-trained nurses and medical technicians in the Philippines. They all speak good English. Back in Saudi Arabia, Filipino nurses and medical staff saved my life when I came down with encephalomyelitis. Something most people my age do not survive.

But they all wanted to come to Canada. 

We need to actively recruit them, and make that easier, by more readily accepting foreign credentials and qualifications.

This is a general problem for immigrants. We bring them in, then won’t let them make a living. 

Again, the problem is red tape. The arbitrary restrictions we now have on foreign professionals is a cartel in restraint of trade.

You asked specifically about mental health. Everyone is alarmed by the opioid crisis.

Mental health is a special concern of mine. 

I once served as the assistant director of The Gathering Spot at Walmer Road Baptist Church, a multifaith outreach to discharged psychiatric patients. 

I was on the Board of Directors of Poverello Charities, which ran a drop-in centre and safe group homes for the mentally ill. 

I was Toronto organizer for Grow International, a faith-based community mental health movement.

I have too much to say about the matter for this brief meeting.

We can’t just throw money at mental health. What we are doing currently is not working. Current psychiatry essentially declares all mental health problems incurable. We’ll just give them safe injection sites, and let them kill themselves. Or we’ll actively kill them, through assisted suicide.

Two centuries ago, we had cure rates of 80 or 90 percent. High cure rates are still found in parts of the Third World.

We are not curing these people, perhaps, because there is no money in it. 

We need to get sufferers out of the city, to a place where they are not anonymous. Mental illness comes from a lack of social supports.

We need, frankly, to evangelize. What do you think that was all about in the New Testament, that healing of demoniacs and driving out devils? Mental illness comes from a lack of meaning in life.

The government can fund faith-based initiatives, so long as it does not play favourites. The Canadian constitution does not recognize any wall of separation between church and state.

And we need to encourage mutual aid and community, such as we see in AA. I am encouraged to have encountered an AA meeting in progress in this church basement.

Safe injection sites are not an answer. Would you treat alcoholism by giving out free booze?

Here again, Critical Theory or postmodernism or cultural Marxism is against us. It alienates us from our neighbours and strips our lives of meaning.

The way to prevent mental illness is to strengthen the family, strengthen religion, and strengthen community. 

Fixing the Health Care System

The aging population is putting an increasing strain on OHIP and other provincial health plans. On the other hand, our current health care system is absurdly inefficient. We ought to be able to cut costs.

The monopoly given to doctors to prescribe causes vast extra costs to nobody's benefit but the doctors'. In the real world, a patient who has been taking a medicine for years is likely to know more about it than the doctor they have to go to to renew a prescription. Proposal: as in some other countries, give pharmacists the right to prescribe. That alone would cut out a huge number of unnecessary doctor visits.

Add a small deductible to public health insurance. This would discourage frivolous doctor and hospital visits, without really keeping anyone who needs it from health care. The true value of health insurance is in covering catastrophic expenses, not a quick clinic visit to see about a nosebleed.

For purely political reasons, we currently publicly fund some voluntary procedures. For financial reasons, even aside from human rights concerns, we should not fund abortion and sex change operations.

We are already at the point that AI software can diagnose more reliably than a human doctor. The rigorous educational qualifications we require of MDs are a waste. We ought to allow someone with the training of a nurse to diagnose and prescribe treatment in most cases, with the aid of diagnostic software, referring on to specialists only for more complicated treatments.

We ought to allow those who want to to pay extra for prompt treatment outside the government system. Yes, this gives the rich an advantage, but it is a matter of human rights--the right to life, and the right to property. Moreover, it helps everyone by taking some strain off the public system--making it easier to give essential care to the poor, with shorter waiting times. The one danger is that doctors might abandon the public system en masse. To prevent this, doctors' fees might be capped; or, better, a certain number of years spent in the public system might be required before a doctor could legally practice outside it.

Makes more sense than rationing treatment, which is where we are now.